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Printable Handouts
Navigable Slide Index
- Introduction
- Regimen-related mucosal injury is not new
- Radiation-induced oral mucositis
- Chemotherapy-induced oral mucositis
- Mucositis: An iconic & prototypical toxicity
- Stomatitis
- Oral mucositis: Worst chemotherapy complication
- Oral mucositis: Worst radiotherapy toxicity
- Frequency of selected outcomes in HNC patients
- Median direct HNC+NSCLC treatment costs
- Mouth, most identifiable bacteremia/sepsis source
- Oral mucositis: Morbidity & mortality
- How common is mucositis?
- Interest in mucositis continues to increase
- Mucositis trajectory following chemotherapy
- Mucositis trajectory in radiation for HNC
- Mucositis development: Buccal mucosa ulceration
- Buccal mucosa with pseudomembrane
- Extended buccal mucosa ulceration
- Diffused mucosal ulceration
- Mucositis pathobiology
- Pro-inflammatory cytokines in mucositis
- Co-morbid conditions affect mucositis risk
- Endothelial damage precedes mucosal changes
- The orange experiment
- Direct and indirect injuries
- Treated cells produce biological elbows
- Clonogenic cell death is not the whole story
- Mucositis is not just an epithelial process
- A multiple mechanism model: Initiation
- Upregulation & message generation
- Signaling & amplification
- Ulceration
- Healing
- Relevant global canonical pathways
- Summary diagram of all stages
- Understanding the complexity of the biology
- Palifermin-induced thickening of tongue mucosa
- Reducing mucositis
- Palifermin’s success, biological pleotrophism
- Changing epidemiology
- New agents – New problems
Topics Covered
- Mucositis induction by radiation & chemotherapy
- The burden of oral mucositis
- Mucositis occurrence & trajectory
- Mucositis development
- Mucositis pathobiology
- Not just an epithelial process
- Therapeutic treatment
Links
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Talk Citation
Sonis, S.T. (2017, June 29). Soreness and ulcers 5: biology, diagnosis and management of cancer regimen 1 [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 22, 2024, from https://doi.org/10.69645/SGHZ6326.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Stephen T. Sonis, Consultant: Clinical Assistance Programs
Soreness and ulcers 5: biology, diagnosis and management of cancer regimen 1
Published on June 29, 2017
33 min
Transcript
Please wait while the transcript is being prepared...
0:00
Thanks for joining me to talk about the "Biology,
Diagnosis & Management of Cancer Regimen-Related Oral Mucosal Injury or Mucositis".
My name is Dr. Stephen Sonis.
I'm at Brigham and Women's Hospital and
the Dana-Farber Cancer Institute in Austin and
I also work with a company called Biomodels.
What I'd like to do this morning is discuss three things really.
One is the epidemiology and the background of oral mucositis,
a little bit about its history,
talk about the pathobiology, the treatment opportunities.
And, finally, how to predict the risk of mucositis
as we move ahead with precision medicine.
0:38
Regimen-related toxicities are not new.
Sidney Farber, who is actually a pathologist at Children's Hospital in Boston,
and was devastated to see the effects of
leukemia on children towards around the end of the Second World War,
one of the first people to use chemotherapy.
And the figure on the right, Madame Curie,
at around the end of the First World War,
started to develop radiation therapy as a treatment modality for tumors.
Both noted, consistently, from the start of their work that oral mucosal toxicities
and oral mucositis mouth sores were
a significant and devastating problem for their patients.
1:19
In this slide, you can see on the left side a historic picture of one
of the early radiation sources for the treatment of cancers. And then on the right,
obviously, a modern picture of a patient with a mask on receiving
intensity modulated radiation therapy for a tumor of the head and neck.
And despite the change in the technology,
virtually 100% of these patients develop toxicities of the oral cavity.
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