Murphy Barbara A
Pain and Symptom Management Program, Vanderbilt University, Nashville, Tennessee 37232-5536, USA.
J Support Oncol. 2007 Oct;5(9 Suppl 4):13-21.
Mucositis is a common complication of cancer therapy and can be a debilitating and dose-limiting toxicity. Nearly all patients with head and neck cancer treated with radiotherapy develop some degree of mucositis, as do the majority of patients undergoing high-dose chemotherapy in conjunction with hematopoietic stem cell transplantation. Mucositis can have significant clinical and economic consequences. It is associated with severe pain that requires opioid analgesics and often results in the loss of critical functions such as speech and swallowing. Swallowing difficulties can lead to dehydration, weight loss, and the need for nutritional support. Furthermore, patients with mucositis are at increased risk of infection. Unscheduled dose reductions or treatment breaks due to severe mucositis may potentially compromise the efficacy of therapy and result in diminished quality of life. Treatment costs for patients with mucositis are substantially higher due to increased rates of hospitalization, opioid use, and a greater need for fluids and nutritional support. Costs generally increase as a function of mucositis severity. Effective treatments to prevent or reduce the incidence and severity of mucositis are needed to decrease function loss, minimize symptom burden, and lower treatment costs.
口腔黏膜炎是癌症治疗中常见的并发症,可能是一种使人虚弱的剂量限制性毒性反应。几乎所有接受放射治疗的头颈癌患者都会出现一定程度的口腔黏膜炎,大多数接受大剂量化疗并伴有造血干细胞移植的患者也是如此。口腔黏膜炎会产生重大的临床和经济后果。它与需要使用阿片类镇痛药的严重疼痛相关,并且常常导致如言语和吞咽等关键功能丧失。吞咽困难会导致脱水、体重减轻以及需要营养支持。此外,患有口腔黏膜炎的患者感染风险增加。由于严重的口腔黏膜炎而导致的计划外剂量减少或治疗中断可能会潜在地损害治疗效果并导致生活质量下降。由于住院率增加、阿片类药物使用以及对液体和营养支持的更大需求,口腔黏膜炎患者的治疗成本大幅更高。成本通常随着口腔黏膜炎严重程度而增加。需要有效的治疗方法来预防或降低口腔黏膜炎的发生率和严重程度,以减少功能丧失、减轻症状负担并降低治疗成本。