Bensadoun R J, Magné N, Marcy P Y, Demard F
Department of Radiation Oncology, Centre Antoine Lacassagne, Nice, France.
Eur Arch Otorhinolaryngol. 2001 Nov;258(9):481-7. doi: 10.1007/s004050100368.
Mucositis is the intensity-limiting toxicity in the management of locally advanced non-resectable head and neck cancer with radiotherapy and chemotherapy. New radiation modalities (hyperfractionation and/or acceleration) as well as combined modality regimens in this situation induce higher rates of acute toxicity. Hyperfractionation, for example, allows higher control rates, with few late toxicities, but it slightly increases acute mucositis. The addition of chemotherapy introduces systemic toxicity and can exacerbate local tissue reactions when used concurrently with radiotherapy. Mucositis is recognized as the principal limiting factor to further treatment intensification. As local regional control and overall survival are related to dose-intensity in this case, further research into the assessment, analysis, prevention and treatment of mucosal toxicity is not only crucial to improvement in quality of life, but certainly also to improved rates of disease control. Several topical and systemic treatments are directed to the decrease and the acceptance of this acute toxicity, but few have shown a significant preventive effect. The efficacy of low-level laser therapy in the management of such toxicity could hence yield important developments with this method in the field of oncology.
黏膜炎是局部晚期不可切除头颈癌放化疗治疗中剂量限制毒性。新的放疗模式（超分割和/或加速放疗）以及在此情况下的联合治疗方案会导致更高的急性毒性发生率。例如，超分割放疗可提高控制率，晚期毒性较少，但会轻微增加急性黏膜炎的发生率。化疗的加入会带来全身毒性，并且与放疗同时使用时会加重局部组织反应。黏膜炎被认为是进一步强化治疗的主要限制因素。由于在此病例中局部区域控制和总生存期与剂量强度相关，因此对黏膜毒性的评估、分析、预防和治疗进行进一步研究不仅对改善生活质量至关重要，而且对提高疾病控制率也肯定至关重要。有几种局部和全身治疗方法旨在降低这种急性毒性并提高其可接受性，但很少有方法显示出显著的预防效果。因此，低强度激光治疗在管理此类毒性方面的疗效可能会在肿瘤学领域通过这种方法取得重要进展。
