Radiation therapy is one of the main treatments for head and neck tumors,and radiationinduced oral mucositis(RIOM)is a common serious adverse effect of radiation therapy.We summarized the pathogenesis,prevention and t...Radiation therapy is one of the main treatments for head and neck tumors,and radiationinduced oral mucositis(RIOM)is a common serious adverse effect of radiation therapy.We summarized the pathogenesis,prevention and treatment methods of RIOM related to traditional Chinese and Western medicine in recent years.The treatment of RIOM in traditional Chinese medicine should be based on clearing heat and detoxifying,nourishing Yin and promoting fluid,tonifying spleen and stomach,cooling blood and removing blood stasis.Osteopontin,immunoglobulin A and saliva flow tests may be effective clinical indicators in the future.Through analysis,the author believes that the use of integrated intervention of traditional Chinese and western medicine can better benefit patients,and the prevention and predictive diagnostic tools of RIOM should become the future focus of attention.展开更多
Objective:To investigate the effect of Kangfuxin Solution(康复新液)combined with low-level laser therapy(LLLT)on cytokines and immune function in patients with radiation-induced oral mucositis.Methods:There were 84 na...Objective:To investigate the effect of Kangfuxin Solution(康复新液)combined with low-level laser therapy(LLLT)on cytokines and immune function in patients with radiation-induced oral mucositis.Methods:There were 84 nasopharyngeal carcinoma patients with oral mucositis after intensity-modulated radiation therapy(IMRT)were randomly divided into the control group(CG)and the observation group(OG),with 42 cases in each group.The CG was given LLLT,and the OG was treated with Kangfuxin Solution in addition to LLLT for 10 consecutive days.The healing time of oral mucosa,mucositis grading,oral pain scores,cytokines(interleukin-6,interleukin-1βand tumor necrosis factor-α)and T lymphocyte subsets were compared between the 2 groups before and after treatment.Results:The healing time of oral mucosa in the OG was(6.8±1.4)d,which was significantly shorter than(8.6±1.9)d in the CG(t=4.943,P<0.01).After treatment,the grading of oral mucositis in the OG was better than that in the CG,with a statistically significant difference(Z=2.942,P<0.05).The oral pain scores of the OG was lower than that in the CG at different time points after treatment,and the difference was statistically significant(t=8.207,11.017,P<0.01).After treatment,the levels of IL-6,IL-1βand TNF-αin peripheral blood of the OG were significantly lower than those in the CG(t=5.217,2.775,4.053,P<0.01).There were statistically significant differences in CD4+,CD8+and CD4+/CD8+between the OG and the CG after treatment(t=5.692,6.093,3.658,P<0.01).Conclusion:Kangfuxin Solution combined with LLLT can significantly shorten the healing time of oral mucosal,reduce the grading of oral mucositis,relieve oral pain,reduce inflammatory response and improve the immune function of patients.展开更多
Objective:To observe clinical efficacy of Lanzhou Formula(兰州方)with Bingpeng Powder(冰硼散)mouthwash in preventing and treating radiation-induced oral mucositis.Methods:A total of 200 patients with malignant tumors ...Objective:To observe clinical efficacy of Lanzhou Formula(兰州方)with Bingpeng Powder(冰硼散)mouthwash in preventing and treating radiation-induced oral mucositis.Methods:A total of 200 patients with malignant tumors in the head and neck who received radiotherapy in our hospital from April 2018 to April 2020 were selected as research objects,and they were randomly divided into the study group and control group.The control group was given radiotherapy combined with mouthwash,which consisted of 500 mL of normal saline,125 mg of vitamin B12,400000 U of gentamicin and 1 g of lidocaine.The study group was given radiotherapy combined with Lanzhou Formula with Bingpeng Powder mouthwash.Incidences of radiation-induced oral mucositis,chewing and swallowing functions,and Karnofsky(KPS)scores were compared between the 2 groups.Results:At the end of the radiotherapy,there was no Grade 4 radiation-induced oral mucositis in the 2 groups.Compared with the control group,the radiation-induced oral mucositis in the study group basically belonged to Grade 1 and Grade 2,with a lower incidence of Grade 3(P<0.05).At the end of the radiotherapy,the chewing and swallowing functions in the 2 groups were decreased,but patients with 2-point chewing and swallowing functions in the study group were more than those in the control group,and patients with the 3-point were less than those in the control group(P<0.05).At the end of the radiotherapy,the KPS scores were decreased,but those in the study group were higher than those in the control group(P<0.05).Conclusion:During radiotherapy for patients with malignant tumors in the head and neck,Lanzhou Formula with Bingpeng Powder mouthwash can decrease the severity of radiation-induced oral mucositis,protect chewing and swallowing functions of patients to a certain extent,and improve the general condition of patients.It is worthy of clinical application and promotion.展开更多
The combination of radiotherapy(RT)and chemotherapy is associated with a high cure rate but an increased risk of radiation-induced oral mucositis(RIOM)in patients with nasopharyngeal carcinoma(NPC).As a dose-limiting ...The combination of radiotherapy(RT)and chemotherapy is associated with a high cure rate but an increased risk of radiation-induced oral mucositis(RIOM)in patients with nasopharyngeal carcinoma(NPC).As a dose-limiting complication,RIOM remains a critical dilemma for patients and physicians,potentially leading to radiation interruptions and compromised tumor control.In this review,we discuss and analyze the pathological mechanisms and factors affecting prevention/treatment of RIOM.RT may induce RIOM via a positive feedback loop,consequently amplifying superoxide production,the immunoinflammatory response,dysbacteriosis,infection,and epithelial basal cell death.Routine interventions for RIOM focus on oral care,oral-pain relief,nutritional support,and infection control;however,recent novel and effective methods have been proposed according to the pathological mechanisms and influencing factors.Some patients with low-recurrence-risk NPCs may be treated with reduced-dose RT,reduced-dose chemotherapy,or RT alone(without chemotherapy)to prevent severe RIOM.Furthermore,traditional herbal medicine extracts,such as Kangfuxin and honey,may help to control RIOM.In addition to the routine application of antibiotics to treat oral dysbacteriosis and hormones to suppress immune inflammatory responses,edaravone and GC4419 can also be used to scavenge oxygen free radicals and reduce superoxide ions to protect the oral mucosa and limit the occurrence of RIOM.展开更多
基金National Natural Science Foundation of China Youth Science Fund Project:Research on the Target and Molecular Mechanism of Wen Tong San Jie Traditional Chinese Medicine in Inhibiting Central Sensitization Therapy for Cancer Pain (project number:82104958)"Beijing Hope Marathon"Special Fund of China Cancer Foundation Key Project:Clinical Study on (Jianhua Guchang Decoction)to Prevent Radioactive Enteritis in Patients with Cervical Cancer (project number:LC2020A21)。
文摘Radiation therapy is one of the main treatments for head and neck tumors,and radiationinduced oral mucositis(RIOM)is a common serious adverse effect of radiation therapy.We summarized the pathogenesis,prevention and treatment methods of RIOM related to traditional Chinese and Western medicine in recent years.The treatment of RIOM in traditional Chinese medicine should be based on clearing heat and detoxifying,nourishing Yin and promoting fluid,tonifying spleen and stomach,cooling blood and removing blood stasis.Osteopontin,immunoglobulin A and saliva flow tests may be effective clinical indicators in the future.Through analysis,the author believes that the use of integrated intervention of traditional Chinese and western medicine can better benefit patients,and the prevention and predictive diagnostic tools of RIOM should become the future focus of attention.
文摘Objective:To investigate the effect of Kangfuxin Solution(康复新液)combined with low-level laser therapy(LLLT)on cytokines and immune function in patients with radiation-induced oral mucositis.Methods:There were 84 nasopharyngeal carcinoma patients with oral mucositis after intensity-modulated radiation therapy(IMRT)were randomly divided into the control group(CG)and the observation group(OG),with 42 cases in each group.The CG was given LLLT,and the OG was treated with Kangfuxin Solution in addition to LLLT for 10 consecutive days.The healing time of oral mucosa,mucositis grading,oral pain scores,cytokines(interleukin-6,interleukin-1βand tumor necrosis factor-α)and T lymphocyte subsets were compared between the 2 groups before and after treatment.Results:The healing time of oral mucosa in the OG was(6.8±1.4)d,which was significantly shorter than(8.6±1.9)d in the CG(t=4.943,P<0.01).After treatment,the grading of oral mucositis in the OG was better than that in the CG,with a statistically significant difference(Z=2.942,P<0.05).The oral pain scores of the OG was lower than that in the CG at different time points after treatment,and the difference was statistically significant(t=8.207,11.017,P<0.01).After treatment,the levels of IL-6,IL-1βand TNF-αin peripheral blood of the OG were significantly lower than those in the CG(t=5.217,2.775,4.053,P<0.01).There were statistically significant differences in CD4+,CD8+and CD4+/CD8+between the OG and the CG after treatment(t=5.692,6.093,3.658,P<0.01).Conclusion:Kangfuxin Solution combined with LLLT can significantly shorten the healing time of oral mucosal,reduce the grading of oral mucositis,relieve oral pain,reduce inflammatory response and improve the immune function of patients.
基金Scientific Research Projects of Gansu Provincial Administration of Traditional Chinese Medicine(GZK-2017-40)。
文摘Objective:To observe clinical efficacy of Lanzhou Formula(兰州方)with Bingpeng Powder(冰硼散)mouthwash in preventing and treating radiation-induced oral mucositis.Methods:A total of 200 patients with malignant tumors in the head and neck who received radiotherapy in our hospital from April 2018 to April 2020 were selected as research objects,and they were randomly divided into the study group and control group.The control group was given radiotherapy combined with mouthwash,which consisted of 500 mL of normal saline,125 mg of vitamin B12,400000 U of gentamicin and 1 g of lidocaine.The study group was given radiotherapy combined with Lanzhou Formula with Bingpeng Powder mouthwash.Incidences of radiation-induced oral mucositis,chewing and swallowing functions,and Karnofsky(KPS)scores were compared between the 2 groups.Results:At the end of the radiotherapy,there was no Grade 4 radiation-induced oral mucositis in the 2 groups.Compared with the control group,the radiation-induced oral mucositis in the study group basically belonged to Grade 1 and Grade 2,with a lower incidence of Grade 3(P<0.05).At the end of the radiotherapy,the chewing and swallowing functions in the 2 groups were decreased,but patients with 2-point chewing and swallowing functions in the study group were more than those in the control group,and patients with the 3-point were less than those in the control group(P<0.05).At the end of the radiotherapy,the KPS scores were decreased,but those in the study group were higher than those in the control group(P<0.05).Conclusion:During radiotherapy for patients with malignant tumors in the head and neck,Lanzhou Formula with Bingpeng Powder mouthwash can decrease the severity of radiation-induced oral mucositis,protect chewing and swallowing functions of patients to a certain extent,and improve the general condition of patients.It is worthy of clinical application and promotion.
文摘The combination of radiotherapy(RT)and chemotherapy is associated with a high cure rate but an increased risk of radiation-induced oral mucositis(RIOM)in patients with nasopharyngeal carcinoma(NPC).As a dose-limiting complication,RIOM remains a critical dilemma for patients and physicians,potentially leading to radiation interruptions and compromised tumor control.In this review,we discuss and analyze the pathological mechanisms and factors affecting prevention/treatment of RIOM.RT may induce RIOM via a positive feedback loop,consequently amplifying superoxide production,the immunoinflammatory response,dysbacteriosis,infection,and epithelial basal cell death.Routine interventions for RIOM focus on oral care,oral-pain relief,nutritional support,and infection control;however,recent novel and effective methods have been proposed according to the pathological mechanisms and influencing factors.Some patients with low-recurrence-risk NPCs may be treated with reduced-dose RT,reduced-dose chemotherapy,or RT alone(without chemotherapy)to prevent severe RIOM.Furthermore,traditional herbal medicine extracts,such as Kangfuxin and honey,may help to control RIOM.In addition to the routine application of antibiotics to treat oral dysbacteriosis and hormones to suppress immune inflammatory responses,edaravone and GC4419 can also be used to scavenge oxygen free radicals and reduce superoxide ions to protect the oral mucosa and limit the occurrence of RIOM.
