接受化疗和放疗的头颈癌患者的口腔毒性管理：牙科病理学和放射性骨坏死（第1部分）文献综述与共识声明

Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: Dental pathologies and osteoradionecrosis (Part 1) literature review and consensus statement.

作者信息

Buglione Michela, Cavagnini Roberta, Di Rosario Federico, Sottocornola Lara, Maddalo Marta, Vassalli Lucia, Grisanti Salvatore, Salgarello Stefano, Orlandi Ester, Paganelli Corrado, Majorana Alessandra, Gastaldi Giorgio, Bossi Paolo, Berruti Alfredo, Pavanato Giovanni, Nicolai Piero, Maroldi Roberto, Barasch Andrei, Russi Elvio G, Raber-Durlacher Judith, Murphy Barbara, Magrini Stefano M

机构信息

Radiation Oncology Department, Spedali Civili Hospital, Brescia University, Italy.

Department of Oral Diagnosis, Oral Medicine & Oral Pathology, Spedali Civili Hospital, Brescia University, Italy.

出版信息

Crit Rev Oncol Hematol. 2016 Jan;97:131-42. doi: 10.1016/j.critrevonc.2015.08.010. Epub 2015 Aug 12.

DOI:10.1016/j.critrevonc.2015.08.010

PMID:26318095

Abstract

Radiotherapy alone or in combination with chemotherapy and/or surgery is the typical treatment for head and neck cancer patients. Acute side effects (such as oral mucositis, dermatitis, salivary changes, taste alterations, etc.), and late toxicities in particular (such as osteo-radionecrosis, hypo-salivation and xerostomia, trismus, radiation caries etc.), are often debilitating. These effects tend to be underestimated and insufficiently addressed in the medical community. A multidisciplinary group of head and neck cancer specialists met in Milan with the aim of reaching a consensus on clinical definitions and management of these toxicities. The Delphi Appropriateness method was used for developing the consensus, and external experts evaluated the conclusions. This paper contains 10 clusters of statements about the clinical definitions and management of head and neck cancer treatment sequels (dental pathologies and osteo-radionecroses) that reached consensus, and offers a review of the literature about these topics. The review was split into two parts: the first part dealt with dental pathologies and osteo-radionecroses (10 clusters of statements), whereas this second part deals with trismus and xerostomia.

摘要

单独放疗或放疗联合化疗和/或手术是头颈癌患者的典型治疗方法。急性副作用（如口腔黏膜炎、皮炎、唾液变化、味觉改变等），尤其是晚期毒性反应（如放射性骨坏死、唾液分泌减少和口干、张口受限、放射性龋齿等），往往使人虚弱。这些影响在医学界往往被低估且未得到充分解决。一组多学科的头颈癌专家在米兰会面，旨在就这些毒性反应的临床定义和管理达成共识。采用德尔菲适宜性方法达成共识，并由外部专家评估结论。本文包含10组关于头颈癌治疗后遗症（牙科病理和放射性骨坏死）的临床定义和管理的陈述，这些陈述已达成共识，并对有关这些主题的文献进行了综述。该综述分为两部分：第一部分涉及牙科病理和放射性骨坏死（10组陈述），而第二部分涉及张口受限和口干。