Abstract：Objective To systematically evaluate the risk factors of oral mucositis after radiotherapy in patients with head and neck cancer, and to provide evidence-based proof for prevention of radioactive oral mucositis in patients with head and neck cancer in clinical practice. Methods PubMed, Embase, MEDLINE, Ovid, Web of Science, the Cochrane Library, CNKI, VIP and Wanfang databases were used to search the literatures about the risk factors of radioactive oral mucositis in patients with head and neck cancer published from dates of the establishment of the databases to June 2020. The literatures were independently screened, extracted and evaluated by two researchers. RevMan 5.3 and stata 12.0 software were used for the meta-analysis. Results A total of 14 articles were enrolled in this analysis (including 5 in English and 9 in Chinese). The results revealed that factors like combined chemotherapy (OR=2.24, 95%CI:1.66-3.02), smoking (OR=2.12, 95%CI:1.45-3.10), drinking (OR=1.58, 95%CI:1.09-2.29), history of diabetes (OR=1.99, 95%CI:1.46-2.70), oral PH value ≤7 (OR=3.11, 95%CI:2.13-4.55), poor oral health (OR=4.38, 95%CI:2.19-8.73), andreceiving no antibiotics (OR=5.92, 95%CI:2.91-12.04) as well as oral mucosal protective agents (OR=5.39, 95%CI: 2.89-10.04) were risk factors for radioactive oral mucositis in head and neck cancer, and the differences were statistically significant (all P<0.05). Conclusion Combined chemotherapy, smoking, drinking, history of diabetes, oral PH value≤7, poor oral health, andreceiving no antibiotics as well as oral mucosal protective agents are risk factors of radioactive oral mucositis in head and neck cancer. Medical staff can take relevant prevention measures to reduce the incidence rate and severity of radioactive oral mucositis in clinical practice.
雷聆艺, 巫瑞雪, 王丁婷, 覃纲. 头颈恶性肿瘤放射性口腔黏膜炎危险因素meta分析[J]. 实用预防医学, 2022, 29(3): 276-280.
LEI Ling-yi, WU Rui-xue, WANG Ding-ting, QIN Gang. Risk factors of radioactive oral mucositis in patients with head and neck cancer: a meta-analysis. , 2022, 29(3): 276-280.
[1] Sroussi HY, Epstein JB, Bensadoun RJ, et al. Common oral complications of head and neck cancer radiation therapy: mucositis, infections,saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis[J].Cancer Med, 2017, 6(12):2918-2931. [2] Daugélaiteé G, Užkuraityté K, Jagelaviéiené E, et al. Prevention and treatment of chemotherapy and radiotherapyinduced oral mucositis[J]. Medicina (Kaunas), 2019, 55(2):25. [3] Elting LS, Cooksley CD, Chambers MS, et al. Risk,outcomes,and costs of radiation-induced oral mucositis among patients with head-and-neck malignancies[J].Int J Radiat Oncol Biol Phys, 2007, 68(4):1110-1120. [4] 张云霄, 付由户, 何明艳, 等.营养支持对鼻咽癌放疗患者影响的meta分析[J].实用预防医学, 2020, 27(4):406-409,445. [5] Vera-Llonch M, Oster G, Hagiwara M, et al. Oral mucositis in patients undergoing radiation treatment for head and neck carcinoma[J]. Cancer, 2006, 106(2):329-336. [6] Pereira IF, Firmino RT, Meira HC, et al. Radiation-induced oral mucositis in Brazilian patients: prevalence and associated ractors[J]. In Vivo, 2019, 33(2):605-609. [7] Saedi HS,Gerami H,Soltanipour S,et al. Frequency of chemoradiotherapy-induced mucositis and related risk factors in patients with the head-and-neck cancers: a survey in the North of Iran[J].Dent Res J (Isfahan),2019, 16(5):354-359. [8] Tao Z, Gao J, Qian L, et al. Factors associated with acute oral mucosal reaction induced by radiotherapy in head and neck squamous cell carcinoma: a retrospective single center experience[J]. Medicine (Baltimore), 2017, 96(50):e8446. [9] 蒋文婷.鼻咽癌伴糖尿病放射性口腔黏膜炎发生率的临床观察[J].医学信息,2017,30(7):61-62. [10] 李小冬,郑晓宇.鼻咽癌调强放疗患者放射性口腔黏膜炎发生的主要相关因素分析[J].南京医科大学学报(社会科学版),2011,11(2):134-137. [11] 王鲁,曹咏梅,史金晔.鼻咽癌调强放疗后放射性口腔黏膜炎发生的危险因素分析[J].中国中西医结合耳鼻咽喉科杂志,2017,25(6):456-459. [12] 庞苏红,衣玉丽.鼻咽癌调强放疗患者放射性口腔黏膜炎相关因素分析[J].药品评价,2020,17(2):59-60,62. [13] 彭伟,陈津,江传慧, 等.血糖水平与鼻咽癌临床特征及放射性口腔黏膜炎相关性分析[J].诊断学理论与实践,2016,15(3):317-321. [14] 张力,洪文松,吴丹进, 等.鼻咽癌放疗引起急性放射性口腔黏膜反应的危险因素分析及护理对策[J].罕少疾病杂志,2020,27(1):43-45. [15] 孙境苑,程敏琼,黄晓萍.鼻咽癌放化疗患者急性黏膜反应的相关危险因素及OREM自护理论的应用效果[J].临床与病理杂志,2020,40(3):711-717. [16] 汤亚莉,周素珠,何嘉文, 等.头颈部恶性肿瘤放疗致口腔黏膜炎的发病情况和相关危险因素分析[J].医学临床研究,2017,34(10):1986-1988. [17] 徐芳,滕海荣,王月霞, 等.鼻咽癌患者放疗后放射性口腔黏膜炎发生的相关因素分析[J].实用预防医学,2019,26(12):1476-1479. [18] 罗东华,洪明晃,郭灵, 等.鼻咽癌放射性口腔粘膜炎多因素分析及建立判别模型的临床价值[J].癌症,2005,24(7):850-854. [19] Nikota JK, Stämpfli MR. Cigarette smoke-induced inflammation and respiratory host defense: insights from animal models[J]. Pulm Pharmacol Ther, 2012,25(4):257-262. [20] Skamagas M, Breen TL, LeRoith D. Update on diabetes mellitus: prevention, treatment, and association with oral diseases[J]. Oral Dis, 2008, 14(2):105-114. [21] Dorocka-Bobkowska B, Zozulinska-Ziolkiewicz D, Wierusz-Wysocka B, et al. Candida-associated denture stomatitis in type 2 diabetes mellitus[J]. Diabetes Res Clin Pract, 2010,90(1):81-86. [22] De Sanctis V, Bossi P, Sanguineti G, et al. Mucositis in head and neck cancer patients treated with radiotherapy and systemic therapies: literature review and consensus statements[J]. Crit Rev Oncol Hematol, 2016, 100:147-166. [23] Chen B, Wang Z, Wang J, et al.The oral microbiome profile andbiomarker in Chinese type 2 diabetes mellitus patients[J]. Endocrine, 2020,68(3):564-572. [24] Pöschl G, Seitz HK. Alcohol and cancer[J]. Alcohol Alcohol, 2004, 39(3):155-165. [25] Pignon JP, le Maître A, Maillard E, et al. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients[J]. Radiother Oncol, 2009, 92(1):4-14. [26] 龚丽俐.放化疗性口腔黏膜炎发生情况及危险因素的研究进展[J].医学综述,2013,19(23):4315-4317.
2022, Vol. 29 
