Alleviation of gastrointestinal mucosal toxicity related to chemotherapy and radiation therapy: The NCCTG experience

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Abstract

Purpose. Cancer patients undergoing chemotherapy and radiation therapy may experience substantial mucosal toxicity. The North Central Cancer Treatment Group (NCCTG) has developed a series of Phase III clinical trials to study agents to alleviate mucosal injury. This manuscript will review this experience. Results. An NCCTG trial demonstrated that oral cryotherapy for 30 minutes is able to decrease 5-FU stomatitis by approximately 50%. This result was replicated in an independent trial. Other NCCTG trials evaluating means of reducing 5-FU-induced stomatitis have demonstrated lack of efficacy for allopurinol mouthwashes, chamomile mouthwashes, a sucralfate slurry, and oral glutamine. Trials evaluating means of alleviating radiation-induced oral mucositis have demonstrated that a chlorhexidine mouthwash is detrimental while oral non-absorbable antibiotic lozenges may provide some marginal benefit, but not enough to recommend it for standard clinical practice. A single trial evaluating radiation-induced esophagitis failed to demonstrate any benefit for a sucralfate slurry. Three trials have been developed to evaluate means for alleviating radiation-induced proctitis. The first trial demonstrated that olsalazine was detrimental in this situation. A second trial, evaluating sucralfate, closed in June 1997. A third trial, designed to evaluate glutamine, is being readied to initiate patient entry. Conclusions. The NCCTG, through a program of randomized, placebo-controlled, clinical trials, has been able to evaluate whether purported treatment options are beneficial for the alleviation of mucosal injury from cancer treatment.

Original languageEnglish (US)
Pages (from-to)193-196
Number of pages4
JournalCancer Research Therapy and Control
Volume9
Issue number3-4
StatePublished - 1999

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Radiotherapy
Mouthwashes
Sucralfate
Drug Therapy
Stomatitis
Neoplasms
Radiation
Glutamine
Fluorouracil
Therapeutics
Chamomile
Proctitis
Phase III Clinical Trials
Allopurinol
Cryotherapy
Chlorhexidine
Esophagitis
Wounds and Injuries
Randomized Controlled Trials
Placebos

Keywords

  • Chemotherapy
  • Mucositis
  • Radiation
  • Stomatitis
  • Toxicity

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

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title = "Alleviation of gastrointestinal mucosal toxicity related to chemotherapy and radiation therapy: The NCCTG experience",
abstract = "Purpose. Cancer patients undergoing chemotherapy and radiation therapy may experience substantial mucosal toxicity. The North Central Cancer Treatment Group (NCCTG) has developed a series of Phase III clinical trials to study agents to alleviate mucosal injury. This manuscript will review this experience. Results. An NCCTG trial demonstrated that oral cryotherapy for 30 minutes is able to decrease 5-FU stomatitis by approximately 50{\%}. This result was replicated in an independent trial. Other NCCTG trials evaluating means of reducing 5-FU-induced stomatitis have demonstrated lack of efficacy for allopurinol mouthwashes, chamomile mouthwashes, a sucralfate slurry, and oral glutamine. Trials evaluating means of alleviating radiation-induced oral mucositis have demonstrated that a chlorhexidine mouthwash is detrimental while oral non-absorbable antibiotic lozenges may provide some marginal benefit, but not enough to recommend it for standard clinical practice. A single trial evaluating radiation-induced esophagitis failed to demonstrate any benefit for a sucralfate slurry. Three trials have been developed to evaluate means for alleviating radiation-induced proctitis. The first trial demonstrated that olsalazine was detrimental in this situation. A second trial, evaluating sucralfate, closed in June 1997. A third trial, designed to evaluate glutamine, is being readied to initiate patient entry. Conclusions. The NCCTG, through a program of randomized, placebo-controlled, clinical trials, has been able to evaluate whether purported treatment options are beneficial for the alleviation of mucosal injury from cancer treatment.",
keywords = "Chemotherapy, Mucositis, Radiation, Stomatitis, Toxicity",
author = "Okuno, {Scott Heitaka}",
year = "1999",
language = "English (US)",
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T1 - Alleviation of gastrointestinal mucosal toxicity related to chemotherapy and radiation therapy

T2 - The NCCTG experience

AU - Okuno, Scott Heitaka

PY - 1999

Y1 - 1999

N2 - Purpose. Cancer patients undergoing chemotherapy and radiation therapy may experience substantial mucosal toxicity. The North Central Cancer Treatment Group (NCCTG) has developed a series of Phase III clinical trials to study agents to alleviate mucosal injury. This manuscript will review this experience. Results. An NCCTG trial demonstrated that oral cryotherapy for 30 minutes is able to decrease 5-FU stomatitis by approximately 50%. This result was replicated in an independent trial. Other NCCTG trials evaluating means of reducing 5-FU-induced stomatitis have demonstrated lack of efficacy for allopurinol mouthwashes, chamomile mouthwashes, a sucralfate slurry, and oral glutamine. Trials evaluating means of alleviating radiation-induced oral mucositis have demonstrated that a chlorhexidine mouthwash is detrimental while oral non-absorbable antibiotic lozenges may provide some marginal benefit, but not enough to recommend it for standard clinical practice. A single trial evaluating radiation-induced esophagitis failed to demonstrate any benefit for a sucralfate slurry. Three trials have been developed to evaluate means for alleviating radiation-induced proctitis. The first trial demonstrated that olsalazine was detrimental in this situation. A second trial, evaluating sucralfate, closed in June 1997. A third trial, designed to evaluate glutamine, is being readied to initiate patient entry. Conclusions. The NCCTG, through a program of randomized, placebo-controlled, clinical trials, has been able to evaluate whether purported treatment options are beneficial for the alleviation of mucosal injury from cancer treatment.

AB - Purpose. Cancer patients undergoing chemotherapy and radiation therapy may experience substantial mucosal toxicity. The North Central Cancer Treatment Group (NCCTG) has developed a series of Phase III clinical trials to study agents to alleviate mucosal injury. This manuscript will review this experience. Results. An NCCTG trial demonstrated that oral cryotherapy for 30 minutes is able to decrease 5-FU stomatitis by approximately 50%. This result was replicated in an independent trial. Other NCCTG trials evaluating means of reducing 5-FU-induced stomatitis have demonstrated lack of efficacy for allopurinol mouthwashes, chamomile mouthwashes, a sucralfate slurry, and oral glutamine. Trials evaluating means of alleviating radiation-induced oral mucositis have demonstrated that a chlorhexidine mouthwash is detrimental while oral non-absorbable antibiotic lozenges may provide some marginal benefit, but not enough to recommend it for standard clinical practice. A single trial evaluating radiation-induced esophagitis failed to demonstrate any benefit for a sucralfate slurry. Three trials have been developed to evaluate means for alleviating radiation-induced proctitis. The first trial demonstrated that olsalazine was detrimental in this situation. A second trial, evaluating sucralfate, closed in June 1997. A third trial, designed to evaluate glutamine, is being readied to initiate patient entry. Conclusions. The NCCTG, through a program of randomized, placebo-controlled, clinical trials, has been able to evaluate whether purported treatment options are beneficial for the alleviation of mucosal injury from cancer treatment.

KW - Chemotherapy

KW - Mucositis

KW - Radiation

KW - Stomatitis

KW - Toxicity

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