Liu Shiyu, Zhao Qin, Zheng Zhuangzhuang, Liu Zijing, Meng Lingbin, Dong Lihua, Jiang Xin
Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, China.
Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun, China.
Front Oncol. 2021 Mar 18;11:642575. doi: 10.3389/fonc.2021.642575. eCollection 2021.
Radiation-induced oral mucositis (RIOM) is one of the most frequent complications in head and neck cancer (HNC) patients undergoing radiotherapy (RT). It is a type of mucosal injury associated with severe pain, dysphagia, and other symptoms, which leads to the interruption of RT and other treatments. Factors affecting RIOM include individual characteristics of HNC patients, concurrent chemoradiation therapy, and RT regimen, among others. The pathogenesis of RIOM is not yet fully understood; however, the release of inflammatory transmitters plays an important role in the occurrence and development of RIOM. The five biological stages, including initiation, primary damage response, signal amplification, ulceration, and healing, are widely used to describe the pathophysiology of RIOM. Moreover, RIOM has a dismal outcome with limited treatment options. This review will discuss the epidemiology, pathogenesis, clinical appearance, symptomatic treatments, and preventive measures related to this disease. We hope to provide a reference for the clinical treatment and prevention of RIOM in HNC patients after RT.
放射性口腔黏膜炎(RIOM)是接受放射治疗(RT)的头颈癌(HNC)患者中最常见的并发症之一。它是一种与严重疼痛、吞咽困难及其他症状相关的黏膜损伤,会导致放疗及其他治疗中断。影响RIOM的因素包括HNC患者的个体特征、同步放化疗及放疗方案等。RIOM的发病机制尚未完全明确;然而,炎症介质的释放 在RIOM的发生和发展中起重要作用。包括起始、初级损伤反应、信号放大、溃疡形成和愈合在内的五个生物学阶段被广泛用于描述RIOM的病理生理学。此外,RIOM的预后不佳,治疗选择有限。本综述将讨论与该疾病相关的流行病学、发病机制、临床表现、对症治疗及预防措施。我们希望为RT后HNC患者RIOM的临床治疗和预防提供参考。