Research progress on biomarkers related to radiotherapy and/or chemotherapy - induced oral mucositis

Radiotherapy and/or chemotherapy-induced oral mucositis is a common oral complication in tumor patients undergoing radiotherapy and/or chemotherapy, which seriously compromises patients’quality of life and even affects anti-tumor treatment. Biomarkers are signal indicators that appear at different biological levels before or during disease. A comprehensive understanding of the biomarkers associated with oral mucositis contributes to the early identification of high-risk patients with oral mucositis and aids in the screening of patients prone to develop severe oral mucositis, guiding the prevention and treatment of oral mucositis. This article reviews the existing biomarkers associated with oral mucositis. The literature review results showed that the biomarkers associated with oral mucositis included growth factors, inflammatory cytokines, genes, plasma antioxidants, and pro - apoptotic proteins/inhibitor of apoptosis proteins. These biomarkers can be used to predict the risk of oral mucositis or facilitate early discrimination of patients prone to exhibit severe radiotherapy and/or chemotherapy-induced oral mucositis. EGF, TNF-α, IL-6, IL-1β and CRP can be used to predict and evaluate the risk and development of oral mucositis, whereas genes such as excision repair cross complementing 1(ERCC1), X-ray repair cross complementing 1(XRCC1), methylenetetrahydrofolate reductase (MTHFR) and tumor necrosis factor receptor superfamily member 1A (TNFRSF1A) have been focus of research in recent years. The genotypes and expression levels of some of these genes exhibit variable capacities to predict the risk and severity of oral mucositis. However, no biomarkers have been used in clinical practice, and more studies are needed in the future to verify the reliability and accuracy of these biomarkers, to provide a reference for the early accurate prevention and treatment of radiation and chemotherapy oral mucositis.