Modern views on the problem of secondary lesions of the oral mucosa as a side effect of complex antitumor treatment
(literature review)
DOI:
https://doi.org/10.11603/2311-9624.2020.2.11396Keywords:
tumors, mucositis, oral cavity, treatment, preventionAbstract
Summary. Modern treatment protocols in oncology involve the use of ionizing radiation and aggressive toxic chemotherapeutic agents, which during treatment in almost 100.0 % of patients cause acute oral mucositis. Untimely and irrational correction of these complications can lead to the cessation of special treatment, changes in the scheme of consciously effective therapy, which in turn can significantly worsen the therapeutic effect of chemotherapy and change the prognosis of the underlying disease. Such patients will need additional examination and treatment. One of the complications that occurs among patients with the use of complex therapy of malignant tumors (in combination with radiation therapy) is radiation osteomyelitis of the jaws, its frequency reaches, according to various authors, up to 5.0–14.0 % of cases. The pathogenesis of this complication includes the level of radiation exposure to tissues, the presence of mechanical damage to soft tissues and bones during or after radiation therapy, and exacerbation of chronic odontogenic foci of infection, which may progress to exacerbation during activation of pathogenic microflora. Therefore, the need for surgical rehabilitation of the oral cavity in a patient with a malignant tumor may occur both before and in the distant periods after radiation therapy. At the present stage of development of dentistry and oncology, protocols for the prevention and treatment of acute oral mucositis have not been developed and tested, modern treatment is mostly symptomatic (partially pathogenetic), it is low efficiency and expensive. Nowadays, prevention of mucositis is reduced to urgent rehabilitation of the oral cavity before chemotherapy (in the presence of carious teeth and manifestations of inflammatory and inflammatory-dystrophic periodontal lesions), doctor's recommendations: soft toothbrush, systematic examination of the oral mucosa. Promising are the development of preventive measures (elimination of irritants, treatment of local foci of chronic infection), the use of anti-inflammatory drugs and correction of the cytokine profile of the inflammatory process of the oral mucosa.
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