Keefe Dorothy M K
Department of Medical Oncology, Royal Adelaide Hospital, South Australia.
Support Cancer Ther. 2006 Apr 1;3(3):154-7. doi: 10.3816/SCT.2006.n.013.
Mucositis is an important toxicity to be aware of in anticancer therapy. It contributes to a reduction in cure rates from cancer. Until recently, it has been poorly understood and therefore has not been well managed. It causes patient distress, delays in treatment administration, and reductions in dose intensity, and it costs the health-care system a large amount of money. Mucositis has traditionally been associated more with hematologic malignancies than with solid tumors, because the incidence of severe mucositis has been much higher with the high-dose chemotherapy regimens used in hematologic malignancies. However, the chemotherapy used in solid tumors also causes mucositis and deserves further study. The separation between oral and gastrointestinal mucositis is potentially false and is being removed, with much research now investigating the entire alimentary canal. There are similarities and differences between radiation therapy- and chemotherapy-induced mucositis, and these have implications for treatment and prevention scheduling and type. Risk prediction is another area that requires more work, but there is real hope that, in the future, we might be able to predict who will suffer from mucositis and in which parts of the alimentary canal, thus enabling us to appropriately target the newer antimucotoxic therapies. The Mucositis Study Goup of the Multinational Association for Supportive Care in Cancer has recently published management guidelines for oral and gastrointestinal mucositis and is in the process of updating them. The guidelines serve as an excellent starting place for future mucositis research because they not only review the available treatments but also discuss mechanisms and epidemiology.
黏膜炎是抗癌治疗中需要关注的一种重要毒性反应。它会导致癌症治愈率降低。直到最近，人们对其了解甚少，因此也未能得到很好的管理。它会给患者带来痛苦，导致治疗延迟以及剂量强度降低，还会给医疗系统造成巨额费用。传统上，黏膜炎更多地与血液系统恶性肿瘤相关，而非实体瘤，因为血液系统恶性肿瘤所采用的高剂量化疗方案导致严重黏膜炎的发生率要高得多。然而，实体瘤治疗中使用的化疗也会引发黏膜炎，值得进一步研究。口腔黏膜炎和胃肠道黏膜炎之间的区分可能并不准确，这种区分正在被打破，现在许多研究都在对整个消化道进行调查。放疗和化疗引起的黏膜炎既有相似之处，也有不同之处，这对治疗以及预防方案的安排和类型都有影响。风险预测是另一个需要更多研究的领域，但确实有希望在未来我们能够预测谁会患上黏膜炎以及在消化道的哪些部位发病，从而使我们能够合理地将更新的抗黏膜炎毒性疗法作为靶点。癌症支持治疗多国协会黏膜炎研究小组最近发布了口腔和胃肠道黏膜炎的管理指南，并且正在对其进行更新。这些指南是未来黏膜炎研究的一个绝佳起点，因为它们不仅回顾了现有的治疗方法，还讨论了发病机制和流行病学。
