Klin Onkol. 2020 Winter;33(6):436-439.
Stomatitis associated with targeted oncological therapy, typically everolimus related one, belongs among the major complications affecting the quality of life of a patient and intensity of his/her oncological treatment. Corticosteroids, especially for topical application, represent a major therapeutic and possibly prophylactic intervention.
Basic summary of clinical characteristics, incidence and overview of possibilities of influencing the incidence of stomatitis related to targeted oncological therapy.
When treated with everolimus, the overall incidence of stomatitis is about two thirds of the patients. A solution with dexamethasone sodium phosphate 0.1mg/mL (0.01%) in the SWISH study showed a significant reduction in the complication when used as prophylactic mouthwash during the treatment with everolimus, and the solution is also suggested by the Europan Society for Medical Oncology guidelines for treatment in stomatitis with ulcers. The availability of topical dexamethasone is variable with respect to the concentration, type of dexamethasone salt and the formula.
Solutions containing dexamethasone are an integral part of oral care during targeted oncological therapy; however, the standardization of indications and prescriptions for standard use in practice still remains an open topic.
与靶向肿瘤治疗相关的口腔黏膜炎,尤其是与依维莫司相关的口腔黏膜炎,是影响患者生活质量和肿瘤治疗强度的主要并发症之一。皮质类固醇,特别是局部应用,是一种主要的治疗方法,可能具有预防作用。
简要总结与靶向肿瘤治疗相关的口腔黏膜炎的临床特征、发生率及影响其发生率的可能性。
在接受依维莫司治疗的患者中,口腔黏膜炎的总发生率约为三分之二。在 SWISH 研究中,使用含 0.1mg/mL(0.01%)磷酸二氢钠地塞米松的溶液作为依维莫司治疗期间的预防性漱口液,可显著降低口腔黏膜炎的发生率,欧洲肿瘤内科学会指南也建议将该溶液用于治疗伴有溃疡的口腔黏膜炎。局部用的地塞米松溶液在浓度、地塞米松盐的类型和配方方面存在差异。
含地塞米松的溶液是靶向肿瘤治疗期间口腔护理的重要组成部分;然而,在实践中标准化其适应证和处方以进行常规应用仍然是一个悬而未决的问题。