Rosenthal David I, Trotti Andrea
Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
Semin Radiat Oncol. 2009 Jan;19(1):29-34. doi: 10.1016/j.semradonc.2008.09.006.
Radiation-induced mucositis (RIM) is a common toxicity for head and neck cancer (HNC) patients. The frequency has increased because of the use of more intensive altered radiation fractionation and concurrent chemotherapy regimens. The extent of the injury is directly related to the mucosal volume irradiated, anatomic subsite exposed, treatment intensity, and individual patient predisposition. The consequences of mucositis include pain, dysphagia including feeding tube dependency, dehydration, micronutrient deficiencies, weight loss, and potentially life-threatening aspiration. Currently, there is no Food and Drug Administration-approved cytoprotective agent that reliably prevents RIM for HNC, but several are under investigation. Strategies to limit the extent of mucositis and to manage its symptoms include basic oral care and supportive medications. Limiting the use of aggressive treatments to truly high-risk cancers and special attention to radiation therapy planning techniques can also help restrict the scope of the problem. This review focuses on mucositis recognition, patient treatment selection, and RIM symptom-management strategies.
放射性口腔黏膜炎（RIM）是头颈癌（HNC）患者常见的一种毒性反应。由于采用了更强化的放疗分割方式改变及同步化疗方案，其发生率有所增加。损伤程度直接与受照射的黏膜体积、暴露的解剖亚部位、治疗强度以及个体患者的易感性相关。口腔黏膜炎的后果包括疼痛、吞咽困难（包括依赖鼻饲管）、脱水、微量营养素缺乏、体重减轻以及可能危及生命的误吸。目前，美国食品药品监督管理局尚未批准能可靠预防头颈癌患者发生放射性口腔黏膜炎的细胞保护剂，但有几种药物正在研究中。限制口腔黏膜炎程度并管理其症状的策略包括基本的口腔护理和支持性药物治疗。将积极治疗仅限于真正的高危癌症，并特别关注放射治疗计划技术，也有助于限制问题的范围。本综述重点关注口腔黏膜炎的识别、患者治疗选择以及放射性口腔黏膜炎的症状管理策略。
