Nicolatou-Galitis Ourania, Athanassiadou Pavlina, Kouloulias Vassilis, Sotiropoulou-Lontou Anastasia, Dardoufas Konstantinos, Polychronopoulou Argy, Gonidi Maria, Kyprianou Konstantinos, Kolitsi Georgia, Skarleas Christos, Pissakas George, Papanikolaou Ioannis S, Kouvaris John
Dental Oncology Unit, Department of Oral Pathology and Surgery, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
Support Care Cancer. 2006 Jul;14(7):753-62. doi: 10.1007/s00520-005-0006-5. Epub 2006 Jan 10.
The aim of the study was to investigate the incidence of herpes simplex virus-1 (HSV-1) infection in mucositis during head and neck cancer radiotherapy.
Sixty patients with malignant head and neck tumor, eligible to receive radiotherapy, who were referred to the Dental Oncology Unit, entered the study. Sixteen patients (26.6%) received concomitant chemotherapy. Mucositis was recorded weekly. Smears taken from the ulcers of mucositis grade 2, or 3, or 4 were stained with Papanicolaou and alkaline phosphatase/antialkaline phosphatase immunocytochemical method to identify HSV-1.
Forty-eight of all 60 patients developed ulcerative mucositis. Smear was available from 29 of 48 patients with ulcerations. HSV-1 infection was identified in 14 of 29 smears available (48.2%). Mucositis healed or was reduced after 1 week of antiviral treatment in 11 of those 14 HSV-1-positive patients; 3 patients responded to 1 g/day of valacyclovir, 7-2 g/day, and 1 patient responded to i.v. acyclovir. Ulcerations recurred after quitting antivirals. Three patients did not respond to 1 g/day of valacyclovir. No HSV-1-negative patient responded to acyclovir (P = 0.000).
HSV-1 was isolated from 14 of 29 available smears taken from 48 patients with ulcerative mucositis. The incidence of HSV-1 infection during radiotherapy was estimated as being 14 of all 48 patients at risk (29.1%). Healing or reduction in the grade of mucositis after antivirals in HSV-1 positive patients, combined with the negative response to antivirals in HSV-1 negative patients, denoted that HSV-1 infection was a component of ulcerative radiation mucositis in those HSV-1-positive patients.
本研究的目的是调查头颈部癌放疗期间单纯疱疹病毒1型（HSV-1）感染在口腔黏膜炎中的发生率。
60例符合放疗条件的头颈部恶性肿瘤患者被转诊至口腔肿瘤科室并进入本研究。16例患者（26.6%）接受了同步化疗。每周记录口腔黏膜炎情况。对2级、3级或4级口腔黏膜炎溃疡处采集的涂片进行巴氏染色以及碱性磷酸酶/抗碱性磷酸酶免疫细胞化学方法染色，以鉴定HSV-1。
60例患者中有48例发生了溃疡性口腔黏膜炎。48例有溃疡的患者中有29例可获得涂片。在可获得的29份涂片中，14份（48.2%）鉴定出HSV-1感染。在这14例HSV-1阳性患者中，11例在抗病毒治疗1周后口腔黏膜炎愈合或减轻；3例患者对每天1克伐昔洛韦有反应，7例对每天2克有反应，1例患者对静脉注射阿昔洛韦有反应。停用抗病毒药物后溃疡复发。3例患者对每天1克伐昔洛韦无反应。没有HSV-1阴性患者对阿昔洛韦有反应（P = 0.000）。
在48例溃疡性口腔黏膜炎患者的29份可获得涂片中，14份分离出HSV-1。放疗期间HSV-1感染的发生率估计为所有48例有风险患者中的14例（29.1%）。HSV-1阳性患者抗病毒治疗后口腔黏膜炎愈合或分级降低，以及HSV-1阴性患者对抗病毒药物无反应，表明HSV-1感染是那些HSV-1阳性患者溃疡性放射性口腔黏膜炎的一个组成部分。
