The most frequent oral problem related to chemotherapy is mucositis (stomatitis), a condition corresponding to the appearance of strong inflammation and very painful lesions (mouth ulcers) in the mucous membranes of the mouth and throat, which can extend to the entire mucous membrane of the gastrointestinal apparatus. Mucositis may also develop during or after radiotherapy, especially when it is performed in the head-neck or chest district.
In 40% of cases, particularly in patients with acute myeloid leukaemia, oral mucositis is associated with oropharyngeal candidiasis: an infection of the mucous membranes of the mouth and throat caused by a fungus normally present harmlessly in the oral cavity, but which can become pathogenic and cause infections when the immune system weakens or in particular conditions. In most cases, the fungus Candida Albicans is the cause of oropharyngeal infections associated with mucositis while, more rarely, different microorganisms such as Candida tropicalis, Candida parapsilosis or of the genus Aspergillus may be involved.
Mucositis always involves damage to the mucous membrane of the oral cavity. Patients with invalidating mucositis are those who have undergone immunosuppressive therapy (myeloablative treatment), to prepare for the blood stem cell transplantation (hematopoietic).
The extent and severity of mucositis depend on the oncological therapy the patient is undergoing, but also on individual factors such as: age, sex, ethnicity, systemic impairment, level of oral hygiene, mucosal characteristics, nutritional status, type of neoplasia , drug-induced oral dryness, previous damage to the oral cavity, smoking and genetic predisposition.