Mucosite induzida por tratamentos oncológicos: revisão bibliográfica
DOI:
https://doi.org/10.31877/on.2014.26.01Palavras-chave:
Mucosite, Quimioterapia, Radioterapia, Paciente OncológicoResumo
A mucosite é uma complicação frequente e debilitante do tratamento oncológico. A mucosite pode ser resultante dos efeitos citotóxicos sistémicos da quimioterapia ou dos efeitos locais da radiação na mucosa oral e gastrointestinal. Estas modalidades de tratamento oncológico, para além de destruírem as células neoplásicas que proliferam rapidamente, também destroem as células epiteliais da mucosa oral e gastrointestinal e podem induzir uma complexa cascata de eventos biológicos que contribuem para a ulceração da mucosa. A mucosite severa tem um impacto significativamente negativo no bem-estar, na qualidade de vida e nas actividades de vida diária do paciente. Pode ainda, comprometer a capacidade deste tolerar os tratamentos planeados, resultando na redução de doses ou adiamentos. A mucosite também pode implicar uma carga económica significativa devido à hospitalização prolongada e ao uso, se necessário, de analgésicos, antibióticos e alimentação parentérica, o que representa um aumento substancial dos custos do tratamento. Recentemente, têm sido publicadas novas guidelines com o intuito de orientar o uso de fármacos e uniformizar as intervenções que contribuem para a resolução da mucosite. Os conhecimentos que o enfermeiro possui na área das ciências médicas e humanas permitem-lhe não só actuar, como compreender, avaliar e investigar as consequências das suas intervenções e sentir e acompanhar a forma como o paciente vive a sua experiência de doença.
Downloads
Referências
Wilkes, J.D.; (1998). Prevention and treatment of oral mucositis following cancer chemotherapy. Semin Oncol. 25: 538-551.
Sonis, S.T.; Elting, L.S.; Keefe, D. et al. (2004).Mucositis Study Section of the Multinational Association for Supportive Care in Cancer; International Society for Oral Oncology. Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology and consequences for patients. Cancer. 100 (9):1995-2005.
Codacci-Pisanelli, G.; Van der Wilt, C.L.; Smid, K. et al.(2002). High-dose 5-fluorouracil with uridine-diphosphoglucose rescue increases thymidylate synthase inhibition but not 5-fluorouracil incorporation into tumors. Oncology.62: 363-370.
Petrelli, N.J.; Rustum, Y.M.; Bruckner, H.; Stablein, D.(1989). The Roswell Park Memorial Institute and Gastrointestinal Tumor Study Group phase III experience with the modulation of 5-fluorouracil by leucovorin improvement of survival and quality of life in patients with advanced colorectal carcinoma. J Clin Oncol. 7:1407-1418.
Levi, F. (1999). Cancer choronotherapy. J Pharm Pharmacol. 51:891-898.
Rau Naidu, M.U.; Venkat Ramana, G.; Usha Rani, P. et al.(2004). Chemotherapy-induced and/or radiation therapy-induced oral mucositis-complicating the treatment of cancer. Neoplasia. 6:423-31.
Clayton, F.; Tessnow, K.A.; Fang, J.C.; Holden, J.A.; Moore, J.G. (2002) Circadian variation of topoisomerase II-alpha in human rectal crypt epithelium: implications for reduction of toxicity of chemotherapy. Mod Pathol.15:1191-1196.
Bjarnason, G.A.; MacKenzie, R.; Hodson, I. et al. (2005). A randomized prospective phase-III study comparing the acute oral mucositis of morning vs. afternoon radiotherapy (RT) in patients (pts) with squamous cell carcinoma of the head and neck (SCCHN): NCIC-CTGHN. J Cin Oncol. 23(16S):5500.
National Institutes of Health Consensus Development Panel. Consensus statement. (1990). Oral complications of cancer therapies. In: National Cancer Institute monographs. Bethesda, MD: US Department of Health and Human Service, Public Health Service National Cancer Institute. 1990; 3-8.
Franzen, L.; Funegard, U.; Ericson, T.; Henriksson, R. (1992) Parotid gland function during and following radiotherapy of malignancies in the head and neck. A consecutive study of salivary flow and patient discomfort. Eur J Cancer. 28:457-462.
Rugg, T.; Saunders, M.I.; Dische, S. (1990). Smoking and mucosal reactions to radiotherapy. J Radiol. 9:185-195.
Sonis, S.T.; Sonis, A.L.; Lieberman, A. (1978). Oral complications in patients receiving treatment for malignancy other than the head and neck. J Am Dent Assoc. 97:468-472.
Balducci, L.; Extermann, M.(2000). Management of cancer in the older person: a practical approach. Oncologist.5:224-237.
Cheng, K.K.F.; Molassiotis, A.; Chang, A.M.; et al.(2001) Evaluation of an care protocol intervention in the prevention of chemotherapy-induced oral mucositis in paediatric cancer patients. Eur J Cancer.37:2056-2063.
Sonis, S.T.; Fey, E.G. (2002). Oral complications of cancer therapy. Oncology. 16:680-686.
Tsalic, M.; Bar-Sela, G.; Benjy, A.; et al.(2003). Severe toxicity related to the 5-fluorouracil/leucoverin combination (the Mayo
Clinic regimen): a prospective study in colorectal cancer patients. Am J Clin Oncol. 26:103-106.
Evans, W.E.; McLeod, H.L.(2003). Pharmacogenomics, drug disposition, drug targets and side effects. N Engl J Med.248: 538-49.
Peterson, D.E.; Minah, G.E.; Overholser, C.D.; et al.(1987). Microbiology of acute periodontal infection in myelosuppressed cancer patients. J Clin Oncol. 5: 1461-1468.
Raber-Durlacher, J.E.(1999). Current practices for management of oral mucocitis in cancer patients. Support Care Cancer.7:71-74.
Berger, A.M.; Eilers, J. (1998). Factors influencing oral cavity status during high-dose antineoplastic therapy: a secondary data analysis. Oncol Nurs Forum. 25: 1623-1626.
McGuire, D.B. (2002). Mucosal tissue injury in cancer therapy. More than mucositis and mouthwash. Cancer Pract. 10:179-191.
Peterson, D.E. (1999). Research advances in oral mucositis. Curr Opin Oncol. 11:261-266.
Lee, J.S.; Murphy, W.K.; Shirinian, M.H.; et al. (1991). Alleviation by leucovorin of the dose-limiting toxicity of edatrexate: potential for improved therapeutic efficacy. Cancer Chemother Pharmacol. 28:199-204.
Rubenstein, E.B.; Peterson, D.E.; Schubert, M.; et al.(2004). Mucositis Study Section of the Multinational Association for Supportive Care in Cancer; International Society for Oral Oncology - Clinical practice guidelines for the prevention and treatment of cancer therapy-induced oral and gastrointestinal mucositis. Cancer. 100: 2026-2046.
Peterson, D.E.; Bensadoun, R.J.; Roila, F.(2010). Management of oral and gastrointestinal mucositis: European Society for Medical
Oncology Clinical Practice Guidelines. Annals of Oncology. 21 (5): 261-265.
National Institutes of Health Consensus Development Panel. Consensus statement. (1990) Oral complications of cancer therapies. In: National Cancer Institute monographs. Bethesda, MD: US Department of Health and Human Service, Public Health Service National Cancer Institute. 3-8.
Sonis, S.T.; Elting, L.S.; Keefe, D.; et al. (2005). Perspectives on cancer therapy-induced mucosal injury. Pathogenisis, measurement, epidemiology and consequences for patients. Cancer. 2004; 100: 1995.
Murphy, B.A. (2007). Clinical and economic consequences of mucositis induced by chemotherapy and/or radiation therapy. The Journal of Supportive Oncology. 5 (9): 13-21.
Elting, L.S.; Cooksley, C.D.; Chambers, M.S.; Cantor, S.B.; Manzullo, E.; Rubenstein, E.B. (2003). The burdens of cancer therapy: clinical and economic outcomes of chemotherapy-induced mucositis. Cancer. 98: 1531-1539.
Fanning, S.R.; Rybicki, L.; Kalaycio, M.; et al. (2006). Severe mucositis is associated with reduced survival after autologous stem cell transplantation for Lymphoid maligancies. British Journal of Haematology. 135: 374-381.
Mandara, J.L.; Trier, J.S. (1994). The functional morphology of the small intestine. In: Johnson LR, Alpers DH, Christensen J, Jacobson ED, Walsh JH, eds – Physiology of the Gastrointestinal Tract. Nova Iorque: Raven Press.
Woo, S.B.; Sonis, S.T.; Monopoli, M.M.; Sonis, A.L. (1993). Alongitudinal study of oral ulcerative mucositis in bone marrow transplant recipients. Cancer. 72: 1612-1617.
Lalla, R.V.; Sonis, S.T.; Peterson, D.E. (2008). Management of Oral Mucositis in Patients with Cancer. Dent Clin North Am.52 (1): 61- viii.
Rubenstein, E.B.; Peterson, D.E.; Schubert, M.; et al. (2004). Mucositis Study Section of the Multinational Association for Supportive Care in Cancer; International Society for Oral Oncology - Clinical practice guidelines for the prevention and treatment of cancer therapy-induced oral and gastrointestinal mucositis. Cancer. 100: 2026-2046.
Peterson, D.E.; Bensadoun, R.J.; Roila, F. (2010). Management of oral and gastrointestinal mucositis: European Society for Medical Oncology Clinical Practice Guidelines. Annals of Oncology. 21 (5): 261-265.
McGuire, D.B.; Correa, M.E.; Johnson, J.; Wienandts, P. (2006). The role of basic oral care and good clinical practice principles in the management of oral mucositis. Support Care in Cancer. 14: 541-547.
Silvarman, S. (2007). Diagnosis and management of oral mucositis. Supportive Oncology. 5(2): 13-21.
Saadeh, C.E. (2005). Chemotherapy and radiotherapy-induced oral mucositis: review of prespective strategies and treatment. Pharmacotherapy. 25: 540-554.
Barasch, A.; Elad, S.; Altam, A.; Damato, K.; Epstein, J. (2006). Antimicrobials, mucosal coating agents, anesthetics, analgesics and nutritional supplements for alimentary tract mucositis. Supportive Care in Cancer. 14 (6): 528-532.
Aisa, Y.; Mori, T.; Kudo, M.; et al. (2005). Oral cryotherapy for the prevention of high-dose melphalan-induced stomatitis in allogeneic hematopoietic stem cell transplant recipients. Supportive Care in Cancer.13 (4): 266-269.
Migliorati, C.A.; Oberle-Edwards, L.; Schubert, M. (2006). The role of alternative and natural agents, cryotherapy, and/or laser for management of alimentary mucositis. Supportive Care in Cancer. 14 (6): 533-540.
Genot, M.T.; Klastersky, J. (2005). Low level laser for prevention and therapy of oral mucositis induced by chemotherapy and/or radiotherapy. Current Opinion in Oncology. 17: 236-240.
Whelan, H.T.; Smits, R.L.J.; Buchman, E.V.; et al. (2001). Effect of NASA light-emitting diode irradiation on wound healing. Journal of Clinical Laser Medicine and Surgery. 19: 305-314.
D’Hondt, L.; Lonchay, C.; André, M.; Canon, J.L. (2006). Oral mucositis induced by anticancer treatments: physiopathology and treatments. Therapeutics and Clinical Risk Management. 2 (2): 159-168.
Wright, J.; Feld, R.; Knox, J. (2005). Chemotherapy-induced oral mucositis: new approaches to prevention and management. Expert Opinion in Drug Safety. 4: 193-200.
Evans, M.E.; Jones, D.P.; Ziegler, T.R.(2003). Glutamine prevents cytokine-induced apoptosis in human colonic eplithelial cells. Journal of Nutrition. 133 (10): 3065-3071.
Wilkes, J.D.(1998). Prevention and treatment of oral mucositis following cancer chemotherapy. Seminars in Oncology. 25: 538-551.
Karthaus, M.; Rosenthal, C.; Huebner, G. (1998). Effect of topical oral G-CSF on oral mucositis: a randomised placebo-controlled trial. Bone Marrow Transplantion. 22: 781-785.
Dazzi, C.; Cariello, A.; Giovanis, P.; et al. (2003). Prophylaxis with GM-CSF mouthwashes does not reduce the frequency and duration of severe oral mucositis in patients with solid tumors undergoing high-dose chemotherapy with autologous peripheral blood stem cell transplantation rescue: a double blind randomised, placebo-controlled study. Annals of Oncology. 14: 559-563.
Kostler, W.J.; Hejna, M.; Wenzel, C.; et al. (2001). Oral mucositis complicating chemotherapy and/or radiotherapy: options for prevention and treatment. Cancer Journal for Clinicians. 51: 290-315.
Borges, L.; Rex, K.L.; Chen, J.N.; et al. (2006). A protective role for Keratinocyte growth factor in a murine model of chemotherapy and radiotherapy-induced mucositis. International Journal of Radiation Oncology, Biology and Physics.66: 254-262.
Spielberger, R.; Stiff, P.; Bensinger, W.; et al. (2004). Palifermin for oral mucositis after intensive therapy for hematologic cancers. New England Journal of Medicine. 351: 2590-2598.
Stiff, P.J.; Emmanouilides, C.; Bensinger, W.; et al. (2006). Palifermin reduces patient-reported mouth and throat soreness and improves patient functioning in the hematopoietic stem-cell transplantation setting. Journal of Clinical Oncology. 24: 5186-5193.
Kostler, W.J.; Hejna, M.; Wenzel, C.; Zielinski, C.C. (2001). Oral mucositis complicating chemotherapy and/or radiotherapy: options for prevention and treatment. Cancer Journal of Clinicians. 51 (5): 290-315.
Pitten, F.A.; Kiefer, T.; Buth, C.; et al. (2003). Do cancer patients with chemotherapy-induced leucopenia benefit from an antiseptic chlorhexidine-based oral rinse? A double-blind, block randomised, controlled study. Journal of Hospital Infection. 53: 283-291.
Filicko, J.; Lazarus, H.M.; Flomenberg, N. (2003). Mucosal injury in patients undergoing hematopoietic progenitor cells transplantation: news approaches to prophylaxis and treatment. Bone Marrow Transplant. 31: 1-10.
Scully, C.; Sonis, S.; Diz, P.D. (2006). Oral mucositis. Oral diseases. 12: 229-241.
Innocenti, M.; Moscatelli, G.; Lopez, S. (2002). Efficacy of Gelclair in reducing pain in palliative care patients with oral lesions: preliminary findings from an open pilot study. Journal of Pain and Symptom Management.24: 456-457.
Miyamoto, C.; et al. (2009). A retrospective match controlled study of supersaturated calcium phosphate oral rinse vs supportive care for radiation-induced oral mucositis. Supportive Care in Cancer.17:857-1039.
Bulechek, G.M.; Butcher, H.K.; Dochterman, J.M. (2010). Classificação das Intervenções de Enfermagem. 5ª edição, Elsevier.
Downloads
Publicado
Como Citar
Edição
Secção
Licença
Direitos de Autor (c) 2023 Marlene Silva, Sandra Carvalho, Cristiana Pereira, José Martínez
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição-NãoComercial-CompartilhaIgual 4.0.
(CINAHL Ultimate database)
