Stephen T. Sonis, DMD, DMSc
Professor of Oral Medicine and Diagnostic Science, Department of Harvard-Forsyth Oral Biology, Harvard School Of Dental Medicine
Senior Physician, Oral and Maxillofacial Surgery and Dentistry, Brigham And Women's Hospital
Chief, Division of Oral Medicine, Surgery, Dana-Farber Cancer Institute
DF/HCC Program AffiliationHead and Neck Cancer
The mouth is a common site for both acute and long term toxicities associated with antineoplastic drug and radiation therapy. Ulcerative mucositis is a common, bothersome, dose-limiting toxicity of both radiation- and chemotherapy. In addition, among myelosuppressed patients, breaks in the oral mucosa caused by mucositis provide a robust portal of entry for oral microorganisms and result in the mouth being the most common identifiable site of bacteremias in this patient population. The oral mucosa is a frequent target tissue of graft-vs-host disease. The lesions that result are often functionally debilitating. The objective of our research is to better understand the pathobiology of these conditions and to investigate new forms of intervention which are mechanistically based. To accomplish this objective, our laboratory has employed innovative animal models for both chemotherapy- and radiation-induced mucositis. Murine models for gvhd are also used. Among the techniques which are used are immunohistochemistry, electron microscopy, PCR, and assays to assess cell proliferation. Bisphosphonates have been associated with osteonecrosis of the jaws. Using a newly developed animal model, we are actively defining the biological events the lead to the condition and correlate with clinical and imaging outcomes. Clinical studies include Phase I, II and III protocols for new therapies to treat or prevent mucosal injuries, development and assessment of outcome measures for stomatotoxicities, and pharmacoeconomic analyses of oral complications of cancer therapies. Since mucositis affects all areas of the GI tract, models to study mechanism and interventions are also being studied for radiation-induced esophagitis, colitis, and proctitis.
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