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Oral mucositis

Última revisão: 19 Aug 2025
Última atualização: 28 Feb 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • history of intensive chemotherapy regimens
  • history of radiation therapy to the oral cavity
  • history of chemoradiation
  • erythema and/or ulceration of oral mucosa
  • oral pain
Detalhes completos

Outros fatores diagnósticos

  • intraoral bleeding
  • dietary impairment and/or weight loss
  • diarrhea
  • nausea and/or vomiting
  • abdominal pain
  • fever
Detalhes completos

Fatores de risco

  • intensive chemotherapy regimens
  • radiation therapy to the oral cavity
  • chemoradiation
  • genetic polymorphisms in drug metabolic enzymes
  • use of targeted therapies and immunotherapies
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • clinical diagnosis
Detalhes completos

Investigações a serem consideradas

  • CBC with differential
  • blood cultures
  • superficial smear of lesion for microscopy
  • fungal culture
  • viral culture or polymerase chain reaction (PCR)
Detalhes completos

Algoritmo de tratamento

Inicial

undergoing hematopoietic stem cell transplant: preventive measures

receiving bolus fluorouracil: preventive measures

receiving radiation therapy to oral cavity: preventive measures

AGUDA

established oral mucositis

Colaboradores

Autores

Ourania Nicolatou-Galitis, DDS, MSc, DrDent

Dentist

Specialist in Oral Medicine and Oral Oncology

Hospital Dentistry

National & Kapodistrian University of Athens

Athens

Greece

Declarações

ONG has received fees from Angelini pharma to author a review article on oral mucositis and is the cofounder and scientific responsible of mycancer, a startup private company which aims to provide a comprehensive medical platform for cancer patients. ONG is an author of several references cited in this topic.

Nikolaos Tsoukalas, MD, MSc, PhD

Medical Oncologist

Associate Director

Department of Oncology

401 General Military Hospital

Athens

Greece

Declarações

NT declares that he has no competing interests.

Agradecimentos

Professor Ourania Nicolatou-Galitis and Dr Nikolaos Tsoukalas would like to gratefully acknowledge Dr Eleni Arvanitou, who contributed to the updating of this topic, and Dr Rajesh V. Lalla, a previous contributor.

Declarações

EA declares that she has no competing interests. RVL serves as a consultant for Galera Therapeutics, Ingalfarma, Mundipharma and Sucampo Pharma, and has received research funding from Onxeo, Sucampo Pharma, Galera Therapeutics, and Novartis.

Revisores

Michael Brennan, DDS, MHS

Associate Chairman and Oral Medicine Residency Director

Department of Oral Medicine

Carolinas Medical Center

Charlotte

NC

Declarações

MB is an author of a reference cited in this topic. MB is part of the Mucositis Study Group of MASCC/ISOO, and participated in the review of mucositis.

Maria Michelagnoli, MB ChB, MD, FRCPCH

Consultant Pediatric and Adolescent Oncologist

University College London Hospitals

London

UK

Declarações

MM declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Elad S, Cheng KKF, Lalla RV, et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer. 2020 Oct 1;126(19):4423-31.Texto completo  Resumo

Peterson DE, Boers-Doets CB, Bensadoun RJ, et al; ESMO Guidelines Committee. Management of oral and gastrointestinal mucosal injury: ESMO clinical practice guidelines for diagnosis, treatment, and follow-up. Ann Oncol. 2015 Sep;26(suppl 5):v139-51.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Oral mucositis images
  • Diagnósticos diferenciais

    • Oral candidiasis
    • Herpes simplex virus infection
    • Graft-versus-host disease
    Mais Diagnósticos diferenciais
  • Guidelines

    • MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy
    • Management of oral and gastrointestinal mucosal injury: ESMO clinical practice guidelines
    Mais Guidelines
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