Scully C, Sonis S, Diz P D
Eastman Dental Institute, University College London, University of London, London, UK.
Oral Dis. 2006 May;12(3):229-41. doi: 10.1111/j.1601-0825.2006.01258.x.
Mucositis and xerostomia are the most common oral complications of the non-surgical therapy of cancer. Mucositis, a common sequel of radio- (DXR), chemo-(CXR) and radiochemo-therapy in patients with cancer, or patients requiring haemopoietic stem cell transplants (HSCT), has a direct and significant impact on the quality of life and cost of care, and also affects survival--because of the risk of infection. Apart from dose reduction, preventive and treatment options for mucositis are scarce, although multiple agents have been tested. Evidence suggests that cryotherapy, topical benzydamine and amifostine might provide some benefit in specific situations. The recombinant human keratinocyte growth factor Palifermin (Kepivance) was recently approved as a mucositis intervention in patients receiving conditioning regimens before HSCT for the treatment of haematological malignancies. A number of mechanistically based interventions are in various stages of development. Unfortunately, many other approaches have not been rigorously tested. This paper reviews the clinical features, prevalence, diagnosis, complications, pathogenesis, prophylaxis and management of mucositis.
黏膜炎和口干症是癌症非手术治疗最常见的口腔并发症。黏膜炎是癌症患者或需要造血干细胞移植(HSCT)的患者接受放疗(DXR)、化疗(CXR)及放化疗后的常见后遗症,对生活质量和护理成本有直接且重大的影响,还会因感染风险而影响生存。除了降低剂量外,尽管已经对多种药物进行了测试,但针对黏膜炎的预防和治疗选择仍然很少。有证据表明,冷冻疗法、外用苄达明和氨磷汀在特定情况下可能会带来一些益处。重组人角质形成细胞生长因子帕利夫明(Kepivance)最近被批准用于接受HSCT前预处理方案治疗血液系统恶性肿瘤的患者的黏膜炎干预。一些基于机制的干预措施正处于不同的研发阶段。不幸的是,许多其他方法尚未经过严格测试。本文综述了黏膜炎的临床特征、患病率、诊断、并发症、发病机制、预防和管理。
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