Wingard J R
Oncology Center, Johns Hopkins Hospital, Baltimore, MD 21205.
NCI Monogr. 1990(9):21-6.
Oral complications of cancer therapy often have systemic consequences. Pain and discomfort are common and can lower intake of fluid and nutrients, which in severe cases can lead to dehydration and malnutrition, requiring hospitalization. Oral infections are frequent accompaniments of cancer treatment. Herpes simplex virus is the most common symptomatic oral viral infection, and, in latently infected patients the virus is frequently reactivated after cytoreductive therapy. Viral (infectious) oral mucositis is often indistinguishable from noninfectious mucositis. Bacterial infections are less commonly observed today, perhaps because of the routine use of empiric broad-spectrum antibiotics; however, many episodes of septicemia in neutropenic patients apparently originate from oral microorganisms. Fungal infections are frequent and are usually due to Candida species. Spread to the esophagus or systemic dissemination can occur. Noninfectious oral mucositis can be used as a marker of toxic effects in other organs, especially hepatic veno-occlusive disease. In bone marrow transplant patients with mucositis, hepatic veno-occlusive disease is six times more frequent than in such patients without mucositis.
癌症治疗的口腔并发症常常会产生全身性后果。疼痛和不适很常见，会导致液体和营养物质摄入减少，严重时可导致脱水和营养不良，需要住院治疗。口腔感染是癌症治疗常见的伴随情况。单纯疱疹病毒是最常见的有症状的口腔病毒感染，在潜伏感染的患者中，该病毒在减瘤治疗后常被重新激活。病毒性（感染性）口腔黏膜炎通常与非感染性黏膜炎难以区分。如今细菌感染较少见，这可能是由于经验性使用广谱抗生素的缘故；然而，许多中性粒细胞减少患者的败血症发作显然源自口腔微生物。真菌感染很常见，通常由念珠菌属引起。可蔓延至食管或发生全身播散。非感染性口腔黏膜炎可作为其他器官毒性作用的一个指标，尤其是肝静脉闭塞性疾病。在患有黏膜炎的骨髓移植患者中，肝静脉闭塞性疾病的发生率是没有黏膜炎的此类患者的6倍。
