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. 2021 Mar 13;29(9):4939–4947. doi: 10.1007/s00520-021-06108-w

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© The Author(s) 2021

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Fig. 3 — Mucositis is the consequence of the cumulative biological effects of the radiation challenge exceeding the intrinsic capacity of physiological protective mechanisms. Increasing the threshold for a gain in biological protection results in consequent increase in the threshold for manifestations of mucosal injury. Interventional strategies that supplement protective mechanisms and pathways or those that stimulate intrinsic mechanisms to optimize their effectiveness have proven to be most effective.