放射性口腔干燥症发病机制与防治研究进展

辐射防护通讯 ›› 2018, Vol. 38 ›› Issue (5): 22-27.

放射性口腔干燥症发病机制与防治研究进展

王国伟¹, 王晓静², 赵保东², 马得勋¹, 王松雷¹, 刘书锋¹

1. 海军第九七一医院崂山分院, 青岛, 266101;
2. 青岛大学附属医院口腔种植中心, 青岛, 266000

收稿日期:2018-08-26 出版日期:2018-10-20 发布日期:2020-07-30
通讯作者: 王晓静, wangxjamy@yahoo.com; 刘书锋, wf8439231@163.com
作者简介:王国伟(1982—), 男, 2005年毕业于第四军医大学口腔医学专业, 学士;2013年毕业于第四军医大学口腔修复学专业, 医学博士;主治医师。从事口腔医学临床与科研工作。
基金资助:
军事口腔医学国家重点实验室开放课题 (2017KB03)

The Pathogenesis, Prevention and Treatment of Radiation Induced Xerostomia

Wang Guowei¹, Wang Xiaojing², Zhao Baodong², Ma Dexun¹, Wang Songlei¹, Liu Shufeng¹

1. Laoshan Branch of PLA 401 Hospital, Qingdao, 266101;
2. Affiliated Hospitalof Qingdao University, Qingdao, 266000

Received:2018-08-26 Online:2018-10-20 Published:2020-07-30

摘要/Abstract

摘要： 放射性口腔干燥症是头颈部恶性肿瘤放射治疗最常见的并发症之一, 可导致口腔内环境紊乱, 严重影响肿瘤患者的生存质量。本文介绍了放射性口腔干燥症发病机制以及预防和治疗的研究进展。

关键词: 放射性损伤, 口腔干燥症, 恶性肿瘤, 放射治疗

Abstract: Radiation-induced xerostomia is one of the most common complications of radiotherapy for head and neck tumors, which could lead to environmental disorders in the oral cavity and seriously affect the life quality of patients with cancer. Thepathogenesis, prevention and treatment of xerostomia of this type are presented.

Key words: Radiation damage, Malignant tumor, Xerostomia, Radiotherapy

中图分类号:

R818.74

王国伟, 王晓静, 赵保东, 马得勋, 王松雷, 刘书锋. 放射性口腔干燥症发病机制与防治研究进展[J]. 辐射防护通讯, 2018, 38(5): 22-27.

Wang Guowei, Wang Xiaojing, Zhao Baodong, Ma Dexun, Wang Songlei, Liu Shufeng. The Pathogenesis, Prevention and Treatment of Radiation Induced Xerostomia[J]. RADIATION PROTECTION BULLETIN, 2018, 38(5): 22-27.

参考文献 34

[1]	Vissink A, van Luijk P, Langendijk J A, et al. Current ideas to reduce or salvage radiation damage to salivary glands[J]. Oral diseases, 2015, 21:e1-10.
[2]	Memtsa P T, Tolia M, Tzitzikas I, et al. Assessment of xerostomia and its impact on quality of life in head and neck cancer patients undergoing radiation therapy[J]. Molecular and clinical oncology, 2017, 6:789-793.
[3]	王伯钧, 徐志文, 吴柳青, 等. 下颌下腺移位预防放疗口干燥症的应用解剖[J]. 中国临床解剖学杂志, 2011, 29(1):55-57.
[4]	Adamson I Y, Bowden D H. Endothelial injury and repair in radiation-induced pulmonary fibrosis[J]. The American journal of pathology, 1983, 112:224-230.
[5]	Pena L A, Fuks Z, Kolesnick R N. Radiation-induced apoptosis of endothelial cells in the murine central nervous system:protection by fibroblast growth factor and sphingomyelinase deficiency[J]. Cancer research, 2000, 60:321-327.
[6]	Almstahl A, Skoogh Andersson J, Alstad T, et al. Explorative study on quality of life in relation to salivary secretion rate in head and neck cancer patients treated with radiotherapy up to 2 years post treatment[J].International journal of dental hygiene, 2018, Aug16.doi:10.1111/idh.12363.
[7]	Cotrim A P, Sowers A, Mitchell J B, et al. Prevention of irradiation-induced salivary hypofunction by microvessel protection in mouse salivary glands[J]. Molecular therapy:the journal of the American Society of GeneTherapy, 2007, 15:2101-2106.
[8]	Kirkiles-Smith N C, Mahboubi K, Plescia J, et al. IL-11 protects human microvascular endothelium from alloinjury in vivo by induction ofsurvivin expression[J]. Journal of immunology, 2004, 172:1391-1396.
[9]	Leslie M D, Dische S. The early changes in salivary gland function during and after radiotherapy given for head and neck cancer[J]. Radiotherapy and oncology: journal of the European Society for Therapeutic Radiologyand Oncology, 1994, 30:26-32.
[10]	Abok K, Brunk U, Jung B, et al. Morphologic and histochemical studies on the differing radiosensitivity of ductular and acinar cells of the rat submandibular gland[J]. Virchows Archiv B, Cell pathology including molecular pathology, 1984, 45:443-460.
[11]	Krishnan M, Tennavan A, Saraswathy S, et al. Acute Radiation-Induced Changes in Sprague-Dawley Rat Submandibular Glands: A Histomorphometric Analysis[J]. World journal of oncology, 2017, 8:45-52.
[12]	Roesink J M, Schipper M, Busschers W, et al. A comparison of meanparotid gland dose with measures of parotid gland function after radiotherapy for head and neck cancer: implications for future trials[J]. International journal of radiation oncology, biology, physics, 2005, 63:1006-1009.
[13]	Salum F G, Medella-Junior F A C, Figueiredo M A Z, et al. Salivaryhypofunction: An update on therapeutic strategies[J]. Gerodontology, 2018, 35(4):305-316.
[14]	Valdez I H, Wolff A, Atkinson J C, et al. Use of pilocarpine during head and neck radiation therapy to reduce xerostomia and salivary dysfunction[J]. Cancer, 1993, 71:1848-1851.
[15]	Lee H J, Kim J S, Moon C, et al. Modification of gamma-radiationresponse in mice by green tea polyphenols[J]. Phytotherapy research:PTR, 2008, 22:1380-1383.
[16]	Peng Z, Xu Z W, Wen W S, et al. Tea polyphenols protect against irradiation-induced injury in submandibular glands' cells: a preliminary study[J]. Archives of oral biology, 2011, 56:738-743.
[17]	Qiong L, Jun L, Jun Y, et al. The effect of Laminaria japonica polysaccharides on the recovery of the male rat reproductive system and mating function damaged by multiple mini-doses of ionizing radiations[J]. Environmentaltoxicology and pharmacology, 2011, 31:286-294.
[18]	Palaniyandi S, Odaka Y, Green W, et al. Adenoviral delivery of Tousled kinase for the protection of salivary glands against ionizing radiation damage[J]. Gene Therapy, 2011, 18(3):275-282.
[19]	Baum B J, Alevizos I, Chiorini J A, et al. Advances in salivary gland gene therapy-oral and systemic implications[J]. Expert opinion on biological therapy, 2015, 15:1443-1454.
[20]	Pringle S, Van Os R, Coppes R P. Concise review: Adult salivary gland stem cells and a potential therapy for xerostomia[J]. Stem cells, 2013, 31:613-619.
[21]	Lin C Y, Chang F H, Chen C Y, et al. Cell therapy for salivary gland regeneration[J]. Journal of dental research, 2011, 90:341-346.
[22]	Lin C Y, Lee B S, Liao C C, et al. Transdifferentiation of bone marrow stem cells into acinar cells using a double chamber system. Journal of theFormosan Medical Association[J]. Taiwan yi zhi, 2007, 106:1-7.
[23]	Nanduri L S, Maimets M, Pringle S A, et al. Regeneration of irradiated salivary glands with stem cell marker expressing cells[J]. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2011, 99:367-372.
[24]	Kojima T, Kanemaru S, Hirano S, et al. Regeneration of radiation damaged salivary glands with adipose-derived stromal cells[J]. The Laryngoscope, 2011, 121:1864-1869.
[25]	Sumita Y, Liu Y, Khalili S, et al. Bone marrow derived cells rescue salivary gland function in mice with head and neck irradiation[J]. The international journal of biochemistry & cell biology, 2011, 43:80-87.
[26]	Tran S D, Sumita Y, Khalili S. Bone marrow-derived cells: A potential approach for the treatment of xerostomia[J]. The international journal ofbiochemistry & cell biology, 2011, 43:5-9.
[27]	Burt R K, Loh Y, Pearce W, et al. Clinical applications of blood-derived and marrow-derived stem cells for nonmalignant diseases[J]. Jama, 2008, 299:925-936.
[28]	Epstein J B, Stevenson-Moore P. A clinical comparative trial of saliva substitutes in radiation induced salivary gland hypofunction[J]. Specialcare in dentistry: official publication of the American Association of HospitalDentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry, 1992, 12:21-23.
[29]	Regelink G, Vissink A, Reintsema H, et al. Efficacy of a syntheticpolymer saliva substitute in reducing oral complaints of patients suffering from irradiation-induced xerostomia[J]. Quintessence international, 1998, 29:383-388.
[30]	Fox N F, Xiao C, Sood A J, et al. Hyperbaric oxygen therapy for the treatment of radiation-induced xerostomia: a systematic review[J]. Oral surgery, oral medicine, oral pathology and oral radiology, 2015, 120:22-28.
[31]	Sherlock S, Way M, Tabah A. Hyperbaric oxygen treatment for the management of radiation-induced xerostomia[J]. Journal of medical imaging and radiation oncology, 2018, Aug16.doi:10.1111/1754-9485.12789.
[32]	Blom M, Dawidson I, Fernberg J O, et al. Acupuncture treatment ofpatients with radiation-induced xerostomia[J]. European journal of cancer Part B, Oral oncology, 1996, 32B:182-190.
[33]	Furness S, Bryan G, McMillan R, et al. Interventions for the management of dry mouth: non-pharmacological interventions[J]. The Cochrane database of systematic reviews, 2013:CD009603.
[34]	Wong R K, Sagar S M, Chen B J, et al. Phase II Randomized Trial ofAcupuncture-Like Transcutaneous Electrical Nerve Stimulation to Prevent Radiation-Induced Xerostomia in Head and Neck Cancer Patients[J]. Journal of the Society for Integrative Oncology, 2010, 8:35-42.