Supportive Treatments for Oncology Patients: Not Just Icing on the Cake
Authors: John F. Deeken
Journal: Annals of Internal Medicine (2010)

Editorials21 September 2010Supportive Treatments for Oncology Patients: Not Just Icing on the CakeJohn F. Deeken, MD and Louis M. Weiner, MDJohn F. Deeken, MDFrom Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007.Search for more papers by this author and Louis M. Weiner, MDFrom Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-6-201009210-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Oral mucositis is a frequent and debilitating complication of cancer chemotherapy and radiation therapy. The symptoms range from mild odynophagia to severe tissue inflammation, edema, and mucosal bleeding that can make eating impossible and—in its most severe form—necessitate intubation to protect a patient's airway. A vicious cycle can ensue as patients experience progressive mucositis during treatment, with worsening pain and dysphagia leading to reduced oral intake and resulting in malnutrition, weight loss, fatigue, and deconditioning. Oral ulcers also increase the risk for bacterial and fungal colonization and for systemic infection in immunocompromised patients (1).Although best characterized in the setting ...References1. Keefe DM, Schubert MM, Elting LS, Sonis ST, Epstein JB, Raber-Durlacher JE, et al; Mucositis Study Section of the Multinational Association of Supportive Care in Cancer and the International Society for Oral Oncology. Updated clinical practice guidelines for the prevention and treatment of mucositis. Cancer. 2007;109:820-31. [PMID: 17236223] CrossrefMedlineGoogle Scholar2. Miller AB, Hoogstraten B, Staquet M, Winkler A. Reporting results of cancer treatment. Cancer. 1981;47:207-14. [PMID: 7459811] CrossrefMedlineGoogle Scholar3. Spielberger R, Stiff P, Bensinger W, Gentile T, Weisdorf D, Kewalramani T, et al. Palifermin for oral mucositis after intensive therapy for hematologic cancers. N Engl J Med. 2004;351:2590-8. [PMID: 15602019] CrossrefMedlineGoogle Scholar4. Rosen LS, Abdi E, Davis ID, Gutheil J, Schnell FM, Zalcberg J, et al. Palifermin reduces the incidence of oral mucositis in patients with metastatic colorectal cancer treated with fluorouracil-based chemotherapy. J Clin Oncol. 2006;24:5194-200. [PMID: 17075109] CrossrefMedlineGoogle Scholar5. Brizel DM, Murphy BA, Rosenthal DI, Pandya KJ, Glück S, Brizel HE, et al. Phase II study of palifermin and concurrent chemoradiation in head and neck squamous cell carcinoma. J Clin Oncol. 2008;26:2489-96. [PMID: 18487568] CrossrefMedlineGoogle Scholar6. 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Long-term follow-up of a phase I/II randomized, placebo-controlled trial of palifermin to prevent graft-versus-host disease (GVHD) after related donor allogeneic hematopoietic cell transplantation (HCT). Biol Blood Marrow Transplant. 2008;14:1017-21. [PMID: 18721764] CrossrefMedlineGoogle Scholar10. Bellm LA, Epstein JB, Rose-Ped A, Martin P, Fuchs HJ. Patient reports of complications of bone marrow transplantation. Support Care Cancer. 2000;8:33-9. [PMID: 10650895] CrossrefMedlineGoogle Scholar11. Sox HC, Greenfield S. Comparative effectiveness research: a report from the Institute of Medicine. Ann Intern Med. 2009;151:203-5. [PMID: 19567618] LinkGoogle Scholar12. Elting LS, Shih YC, Stiff PJ, Bensinger W, Cantor SB, Cooksley C, et al. Economic impact of palifermin on the costs of hospitalization for autologous hematopoietic stem-cell transplant: analysis of phase 3 trial results. Biol Blood Marrow Transplant. 2007;13:806-13. [PMID: 17580258] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: John F. Deeken, MD; Louis M. Weiner, MDAffiliations: From Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-1941.Corresponding Author: Louis M. Weiner, MD, Lombardi Comprehensive Cancer Center, 501 New Research Building, Georgetown University Medical Center, 3800 Reservoir Road NW, Washington, DC 20007; e-mail, weinerl@georgetown.edu.Current Author Addresses: Dr. Weiner: Lombardi Comprehensive Cancer Center, 501 New Research Building, Georgetown University Medical Center, 3800 Reservoir Road NW, Washington, DC 20007.Dr. Deeken: Podium B, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3800 Reservoir Road NW, Washington, DC 20007. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSingle-Dose Palifermin Prevents Severe Oral Mucositis During Multicycle Chemotherapy in Patients With Cancer Saroj Vadhan-Raj , Jonathan Trent , Shreyaskumar Patel , Xiao Zhou , Marcella M. Johnson , Dejka Araujo , Joseph A. Ludwig , Shana O'Roark , Ann M. Gillenwater , Carlos Bueso-Ramos , Adel K. El-Naggar , and Robert S. Benjamin Metrics 21 September 2010Volume 153, Issue 6Page: 411-412KeywordsAnalgesicsCancer chemotherapyCancer treatmentChemotherapyColorectal cancerPatientsQuality of lifeRadiation therapySarcomaToxicity ePublished: 21 September 2010 Issue Published: 21 September 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...