Dietrich Em, Antoniades K
Department of Oral and Maxillofacial Surgery, General Hospital "G. Papanikolaou", Thessaloniki, Greece.
Hippokratia. 2012 Jul;16(3):196-9.
Targeted cancer therapy is a new approach for the treatment of cancer. It involves a specific molecular target, mainly a receptor that serves as a target for monoclonal antibodies or tyrosine kinase inhibitors. Side-effects of these new regimens are described to be mild, compared to those of classical chemotherapy. There is a lack in the documentation and understanding of oral complications related to molecularly targeted drugs.
In this review, we tried to make a systematic review of the databases Pubmed and Scopus, using "targeted cancer therapy" and "oral", or "mucositis", or "stomatitis", or "bleeding", or "hemorrhage" as search terms. Specific drug name searches were not conducted. The search yielded 97 results. Only articles related to EGFR and VEGFR inhibition were selected. Finally 13 articles met the criteria. RESULTS are discussed and possible pathogenetic mechanisms for the complications of targeted cancer therapy regimens are presented.
It appears that the most serious side-effect is mucositis/stomatitis that may affect the whole gastrointestinal tract. It rarely results in treatment discontinuation. Reduced saliva secretion, xerostomia and dysphagia can be severe with some regimens and interfere with food uptake. Osteonecrosis, wound healing impairment, spontaneous gingival bleeding and dysgeusia were also reported.
Considering these data it is obvious that symptoms related to cancer treatment should be considered in the context of the holistic management of patients. Oral complications should not be ignored but recorded during physical examination, because they may significantly impair daily activities and patients' quality of life.
靶向癌症治疗是一种治疗癌症的新方法。它涉及一个特定的分子靶点，主要是一种作为单克隆抗体或酪氨酸激酶抑制剂靶点的受体。与传统化疗相比，这些新治疗方案的副作用被描述为较轻。目前缺乏关于分子靶向药物相关口腔并发症的文献记录和了解。
在本综述中，我们试图对数据库PubMed和Scopus进行系统综述，使用“靶向癌症治疗”和“口腔”，或“粘膜炎”，或“口腔炎”，或“出血”作为检索词。未进行特定药物名称检索。检索结果有97条。仅选择与表皮生长因子受体（EGFR）和血管内皮生长因子受体（VEGFR）抑制相关的文章。最终有13篇文章符合标准。对结果进行了讨论，并提出了靶向癌症治疗方案并发症可能的发病机制。
似乎最严重的副作用是可能影响整个胃肠道的粘膜炎/口腔炎。它很少导致治疗中断。某些治疗方案可能会导致严重的唾液分泌减少、口干和吞咽困难，并干扰食物摄取。还报告了骨坏死、伤口愈合受损、自发性牙龈出血和味觉障碍。
考虑到这些数据，显然在患者的整体管理背景下应考虑与癌症治疗相关的症状。口腔并发症不应被忽视，而应在体格检查时记录下来，因为它们可能会严重损害日常活动和患者的生活质量。
