Supportive Care: Mucositis and Stomatitis

Question 1

Complications of mucositis

Answer 1

Decreased PO intake, increased infection risk, pain

Question 2

Mucositis defintion

Answer 2

erythematous and ulcerative lesions of the mucosa observed in patients treated with chemo, can occur anywhere in the GI tract

Question 3

Stomatitis defintion

Answer 3

Limited to oral cavity

Question 4

Chemo risk factors for stomatitis

Answer 4

melphalan, cisplatin and radiation, high-dose MTX, doxorubicin, busulfan, 5-FU

Question 5

Patient risk factors for stomatitis

Answer 5

smoking, poor PO hygiene, PO lesions at baseline, female, pretreatment nutritional status

Question 6

Prevention of stomatitis: PO hygiene

Answer 6

avoid acidic or spicy foods, brushing with a soft toothbrush BID, floss QD; switch tablets to solutions or IV if hospitalized, use nonalcohol-based bland mouthwashes at least QID (NS, salt and soda)

Question 7

Prevention of stomatitis: cryotherapy

Answer 7

local vasoconstriction → less drug delivered to the PO mucosa; hold ice chips in mouth for 30 minutes before and/or during infusion of chemo

Question 8

Management of stomatitis: PO decontamination

Answer 8

bland mouthwash or oncology mouthwash (magic mouthwash), dexamethasone mouthwash for Everolimus-induced mucositis

Question 9

Management of stomatitis: pain control

Answer 9

2% viscous lidocaine; swish and spit; systemic opioids

Question 10

Management of stomatitis: palliation of dry mouth

Answer 10

artificial saliva products or chewing gum to increase saliva production

Question 11

Management of stomatitis: nutritional support

Answer 11

liquid or soft diet; TPN