Oral mucositis: The hidden side of cancer therapy

Claudio Pulito, Antonio Cristaudo, Caterina La Porta, Stefano Zapperi, Giovanni Blandino, Aldo Morrone, Sabrina Strano

Research output: Contribution to journalReview articlepeer-review


Inflammation response of epithelial mucosa to chemo-radiotherapy cytotoxic effects leads to mucositis, a painful side effect of antineoplastic treatments. About 40% of the patients treated with chemotherapy develop mucositis; this percentage rises to about 90% for head and neck cancer patients (HNC) treated with both chemo- A nd radiotherapy. 19% of the latter will be hospitalized and will experience a delay in antineoplastic treatment for high-grade mucositis management, resulting in a reduction of the quality of life, a worse prognosis and an increase in patient management costs. Currently, several interventions and prevention guidelines are available, but their effectiveness is uncertain. This review comprehensively describes mucositis, debating the impact of standard chemo-radiotherapy and targeted therapy on mucositis development and pointing out the limits and the benefits of current mucositis treatment strategies and assessment guidelines. Moreover, the review critically examines the feasibility of the existing biomarkers to predict patient risk of developing oral mucositis and their role in early diagnosis. Despite the expression levels of some proteins involved in the inflammation response, such as TNF-α or IL-1β, partially correlate with mucositis process, their presence does not exclude others mucositis-independent inflammation events. This strongly suggests the need to discover biomarkers that specifically feature mucositis process development. Non-coding RNAs might hold this potential.

Original languageEnglish
Article number210
JournalJournal of Experimental and Clinical Cancer Research
Issue number1
Publication statusPublished - Oct 7 2020


  • Biomarker
  • Cytokine
  • HNC
  • Non-coding RNA
  • Oral mucositis
  • Quality of life

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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