国际口腔医学杂志

国际口腔医学杂志 ›› 2019, Vol. 46 ›› Issue (6): 711-717.doi: 10.7518/gjkq.2019101

• 综述 • 上一篇    下一篇

放射性口腔干燥症的评估与临床管理的研究进展

陈东,杨征,蒋丽()   

  1. 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院全科门诊 成都 610041
  • 收稿日期:2019-03-09 修回日期:2019-07-15 出版日期:2019-11-01 发布日期:2019-11-14
  • 通讯作者: 蒋丽
  • 作者简介:陈东,医师,学士,Email： 763194589@qq.com

Research progress on the evaluation and management of radiation-induced xerostomia

Chen Dong,Yang Zheng,Jiang Li()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of General Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2019-03-09 Revised:2019-07-15 Online:2019-11-01 Published:2019-11-14
  • Contact: Li Jiang

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摘要：

放射性口腔干燥症是头颈部肿瘤放射治疗术后常见的并发症,严重影响了患者的生存质量。本文主要讨论放射性口腔干燥症的评估方法,包括唾液分泌功能检测、影像学检查方法和主观评估方法,以及放射治疗前、中、后期对口腔干燥症的临床管理措施,为降低放射性口腔干燥症的发生率、缓解症状及提高患者的生存质量提供了理论依据和方法。

关键词: 头颈部肿瘤, 放射治疗, 口腔干燥症, 唾液腺, 生存质量

Abstract:

Radiation-induced xerostomia is a common complication after radiotherapy for head and neck cancer. It significantly affects quality of life in survivors of head and neck cancer. In this review, the evaluations of xerostomia including saliva secretion function, imaging examinations and subjective measurements were discussed, as well as the management before, during and after radiotherapy. They provided evidence and approach for reducing morbidity of xerostomia and increasing quality of life in patients under radiotherapy.

Key words: head and neck neoplasms, radiotherapy, xerostomia, salivary glands, quality of life

中图分类号: 

  • R730.55

表 1

RTOG/EORTC评价标准"

分级 急性腺体损伤 晚期腺体损伤
0 无改变 无改变
Ⅰ 轻微口干,唾液略微变稠,轻度味觉稍改变如金属味,这些改变不影响进食习惯如餐中饮水增加 弥散性红斑,轻微口干,唾液略微变稠,轻度味觉稍改变如金属味,进食习惯改变如餐中饮水增加
Ⅱ 中等至完全口干,黏稠的唾液,显著味觉改变 小型溃疡,中等至完全口干,唾液黏稠
Ⅲ - 半数以上口腔黏膜疼痛性溃疡和/或急性唾液腺坏死
Ⅳ 急性唾液腺坏死 纤维化

表 2

LENT/SOMA评分系统"

项目 1级 2级 3级 4级
主观（S） 偶尔口干 部分但能忍受口干 完全口干,身体未衰弱 完全口干,身体衰弱
客观（O） 正常湿润唾液 唾液缺乏湿润 无湿润,黏稠的唾液 无湿润,被覆黏膜的唾液
管理（M） - 偶尔使用人工唾液、口香糖或增唾液药物 经常使用人工唾液或喝水、口香糖或增唾液药物 完全需要人工唾液或喝水来进食、使用口香糖或增唾液药物
数据分析（A） SFR为术前76%~95% SFR为术前51%~75% SFR为术前26%~50% SFR为术前0~25%
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