Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts 02115, USA.
Anticancer Drugs. 2011 Aug;22(7):607-12. doi: 10.1097/CAD.0b013e3283462086.
Oral mucositis remains one of the most common and troubling side effects of standard chemoradiation regimens used for the treatment of head and neck cancer. Virtually all patients who receive cumulative radiation doses of more than 30 Gy that includes oral mucosal fields will develop the condition. Not only does mucositis cause extreme discomfort, often necessitating opioid analgesia, but it is also associated with increased use of health resources and cost of treatment. The incremental cost of mucositis in patients with head and neck cancer is more than $17 000 (US). Much has been learned about the pathobiology that underlies the condition. The departure from the historical paradigm of direct cell death as being the primary cause for mucosal injury in favor of a more comprehensive view of the impact of chemoradiation on all the cells of the mucosa, has resulted in a picture of mucositis pathogenesis, which is biologically broad based. Although there are currently few treatment options for oral mucositis at the moment, the recognition that its underlying biology is complex has provided a range of treatment options that are currently being developed.
口腔黏膜炎仍然是头颈部癌症标准放化疗方案最常见和最令人困扰的副作用之一。几乎所有接受累积剂量超过 30Gy 且包含口腔黏膜野的放射治疗的患者都会出现这种情况。口腔黏膜炎不仅会导致极度不适，通常需要使用阿片类镇痛药，还会增加卫生资源的使用和治疗成本。头颈部癌症患者的口腔黏膜炎增量成本超过 17000 美元（US）。人们已经对其发病机制有了很多了解。从直接细胞死亡是导致黏膜损伤的主要原因的历史范式转变，转而更全面地了解放化疗对黏膜所有细胞的影响，这导致了口腔黏膜炎发病机制的出现，这种发病机制具有广泛的生物学基础。尽管目前口腔黏膜炎的治疗选择很少，但认识到其潜在生物学的复杂性为目前正在开发的一系列治疗选择提供了依据。
