Chambers Mark S, Garden Adam S, Kies Merrill S, Martin Jack W
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA.
Head Neck. 2004 Sep;26(9):796-807. doi: 10.1002/hed.20045.
Xerostomia is a common, debilitating complication of radiation therapy (RT) for head and neck cancer. This article reviews the pathogenesis of radiation-induced xerostomia, its impact on quality of life (QOL), and treatment options.
Virtually all patients undergoing RT for head and neck cancers have xerostomia, which causes oral discomfort and pain, increased dental caries and oral infection, and difficulty speaking and swallowing. This significantly impairs QOL and can compromise nutritional intake and continuity of cancer therapy. The literature describing pathogenesis, impact on QOL of radiation-induced xerostomia, and preventive and interventional therapies was reviewed.
Current management strategies include stringent dental and oral hygiene; parotid-sparing radiation techniques to prevent or minimize xerostomia; and pharmacotherapies, such as salivary substitutes and sialogogues. Future strategies may include advanced three-dimensional intensity-modulated RT techniques, salivary gland transfer, newer sialogogues, and gene therapy.
New treatment approaches to xerostomia from RT for head and neck cancer may result in significant improvement in patient QOL.
口干症是头颈部癌放射治疗（RT）常见的、使人衰弱的并发症。本文综述了放射性口干症的发病机制、其对生活质量（QOL）的影响以及治疗选择。
几乎所有接受头颈部癌放疗的患者都会出现口干症，这会导致口腔不适和疼痛、龋齿和口腔感染增加，以及说话和吞咽困难。这会显著损害生活质量，并可能影响营养摄入和癌症治疗的连续性。本文回顾了描述放射性口干症发病机制、对生活质量的影响以及预防和干预治疗的文献。
目前的管理策略包括严格的牙齿和口腔卫生；保留腮腺的放射技术以预防或最小化口干症；以及药物治疗，如唾液替代品和催涎剂。未来的策略可能包括先进的三维调强放疗技术、唾液腺移植、更新的催涎剂和基因治疗。
头颈部癌放疗引起的口干症的新治疗方法可能会显著改善患者的生活质量。
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