Bockel S, Vallard A, Lévy A, François S, Bourdis M, Le Gallic C, Riccobono D, Annede P, Drouet M, Tao Y, Blanchard P, Deutsch É, Magné N, Chargari C
Département de radiothérapie, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
Département de radiothérapie, institut de cancérologie Lucien-Neuwirth, 108, bis avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France.
Cancer Radiother. 2018 Sep;22(5):429-437. doi: 10.1016/j.canrad.2017.11.006. Epub 2018 May 26.
Radiation-induced mucositis is a common toxicity, especially in patients with head and neck cancers. Despite recent technological advances in radiation therapy, such as intensity-modulated radiotherapy, radiation-induced mucositis is still causing treatment disruptions, negatively affecting patients' long and short term quality of life, and impacting medical resources use with economic consequences. The objective of this article was to review the latest updates in the management of radiation-induced mucositis, with a focus on pharmaceutical strategies for the prevention or treatment of mucositis. Although numerous studies analysing the prevention and management of oral radiation-induced mucositis have been conducted, there are still few reliable data to guide daily clinical practice. Furthermore, most of the tested drugs have shown no (anti-inflammatory cytokine, growth factors) or limited (palifermin) effect. Therapies for acute oral mucositis are predominantly focused on improving oral hygiene and providing symptoms control. Although low-level laser therapy proved efficient in preventing radiation-induced oral mucositis in patients with head and neck cancer, this intervention requires equipment and trained medical staff, and is therefore insufficiently developed in clinical routine. New effective pharmacological agents able to prevent or reverse radio-induced mucositis are required.
放射性口腔黏膜炎是一种常见的毒性反应，在头颈部癌症患者中尤为常见。尽管近年来放射治疗技术取得了进展，如调强放射治疗，但放射性口腔黏膜炎仍会导致治疗中断，对患者的长期和短期生活质量产生负面影响，并影响医疗资源的使用，造成经济后果。本文的目的是综述放射性口腔黏膜炎管理的最新进展，重点关注预防或治疗黏膜炎的药物策略。尽管已经进行了大量分析口腔放射性黏膜炎预防和管理的研究，但仍缺乏可靠数据来指导日常临床实践。此外，大多数受试药物未显示出效果（抗炎细胞因子、生长因子）或效果有限（帕利夫明）。急性口腔黏膜炎的治疗主要集中在改善口腔卫生和控制症状。尽管低强度激光治疗被证明对预防头颈部癌症患者的放射性口腔黏膜炎有效，但这种干预需要设备和训练有素的医务人员，因此在临床常规中应用不足。需要能够预防或逆转放射性黏膜炎的新型有效药物。
