Li Kejie, Ren Xiaolin, Xie Raoying
Department of Radiation and Medical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China.
Heliyon. 2023 May 4;9(5):e15955. doi: 10.1016/j.heliyon.2023.e15955. eCollection 2023 May.
Oral mucositis causes substantial morbidity during head and neck radiotherapy, especially nasopharyngeal carcinoma. During radiotherapy, patients develop severe oral mucositis, which leads to oral pain and difficulty in eating and interruption of radiotherapy, affects the treatment effect and increase the probability of recurrence. Although we have explored various methods to reduce the mucosal damage caused by radiotherapy, these methods still cannot reduce pain caused by mucositis clinically. Therefore, the use of Dexamethasone-Lidocaine-Vitamin B12 Mouth rinse (DLVBM) proved its role in reducing oral mucosal pain, reducing the weight loss of patients, and completing radiotherapy according to the course of treatment. 133 patients with nasopharyngeal carcinoma who received radiotherapy (a total dose of 70 Gy) in our hospital from January to December 2020-2021 were selected. 67 patients received DLVBM treatment for mucositis reaction, and 66 patients received Compound chlorhexidine mouthwash (CCM) to deal with mucositis. Symptoms related to oral mucosal pain score and body weight, mucosal healing time were analyzed retrospectively. We found that patients with the DLVBM group significantly reduced oral pain and reduced weight loss. However, there was no significant difference about the mucosal healing time between the DLVBM group and CCM group. DLVBM may be moderately more effective in preventing radiation-induced mucositis and mucositis-related pain, and their use may lead to less frequent RT course interruptions from mucositis.
口腔黏膜炎在头颈部放疗期间,尤其是鼻咽癌放疗期间会导致严重的发病率。在放疗过程中,患者会出现严重的口腔黏膜炎,这会导致口腔疼痛、进食困难以及放疗中断,影响治疗效果并增加复发概率。尽管我们已经探索了各种方法来减少放疗引起的黏膜损伤,但这些方法在临床上仍无法减轻黏膜炎引起的疼痛。因此,地塞米松-利多卡因-维生素B12漱口水(DLVBM)在减轻口腔黏膜疼痛、减少患者体重减轻以及按疗程完成放疗方面证明了其作用。选取了2020年1月至2021年12月在我院接受放疗(总剂量70 Gy)的133例鼻咽癌患者。67例患者接受DLVBM治疗黏膜炎反应,66例患者接受复方氯己定漱口水(CCM)处理黏膜炎。对口腔黏膜疼痛评分、体重、黏膜愈合时间等相关症状进行回顾性分析。我们发现DLVBM组患者的口腔疼痛明显减轻,体重减轻也有所减少。然而DLVBM组和CCM组在黏膜愈合时间方面没有显著差异。DLVBM在预防放射性口腔黏膜炎及黏膜炎相关疼痛方面可能有中度更好的效果,使用它们可能会减少因黏膜炎导致的放疗疗程中断频率。