文章：

亚甲蓝用于头颈部癌症治疗期间放射性口腔黏膜炎的治疗：一项非对照队列研究

Methylene Blue for the Treatment of Radiation-Induced Oral Mucositis during Head and Neck Cancer Treatment: An Uncontrolled Cohort

原文发布日期：7 August 2023

DOI: 10.3390/cancers15153994

类型: Article

开放获取: 是

英文摘要：

Pain from radiation-therapy-induced oral mucositis during head-neck cancer treatment is aggravated by concurrent chemotherapy and commonly fails traditional treatments. To explore safe and sustainable alternatives, we investigated methylene blue oral rinse to reduce radiation-therapy-related oral mucositis pain. For this, we conducted a retrospective observational cohort study in a tertiary-care academic care cancer center including 85 patients with refractory oral mucositis pain during radiation therapy for head-neck cancer. Changes in pain (scale 0–10), oral function burden (scale 0–6) and requirement for percutaneous endoscopic gastrostomy tube placement were measured. Among 58 patients, 60% received radiation therapy alone and 40% received concurrent chemotherapy-radiation therapy. Methylene blue oral rinse (MBOR) significantly decreased oral mucositis pain for at least 6.2 h (median + SD 8 ± 1.68 before vs. 2 ± 2.20 after;p< 0.0001) and oral function burden (3.5 ± 1.33 before vs. 0 ± 0.86 after;p< 0.0001). Eleven patients (19%) had percutaneous endoscopic gastrostomy tubes placed before using methylene blue oral rinse; subsequently, four (36%) resumed oral alimentation after methylene blue oral rinse. Two patients (3%) required percutaneous endoscopic gastrostomy tubes despite methylene blue oral rinse. Minimal adverse events were reported (n= 9, 15%). Our study showed that methylene blue oral rinse was an effective and safe topical treatment for opioid-refractory oral pain from oral mucositis associated with radiation therapy for head-neck cancer.

摘要翻译： 

在接受头颈癌放疗期间，由放射治疗引起的口腔黏膜炎疼痛在联合化疗时会加重，并且常规治疗通常难以缓解。为了探索安全且可持续的替代疗法，我们研究了使用亚甲蓝口腔冲洗减轻放射治疗相关口腔黏膜炎疼痛的效果。为此，我们在一家三级学术医疗癌症中心开展了一项回顾性观察性队列研究，共纳入85例在接受头颈癌放疗期间出现难治性口腔黏膜炎疼痛的患者。测量指标包括疼痛程度（0–10分量表）、口腔功能负担（0–6分量表）及经皮内镜胃造瘘管放置需求的变化。在58例患者中，60%仅接受放疗，40%接受同步放化疗。亚甲蓝口腔冲洗（MBOR）显著降低了口腔黏膜炎疼痛程度，镇痛效果至少持续6.2小时（中位数±标准差：治疗前8±1.68 vs. 治疗后2±2.20，p<0.0001），同时显著减轻了口腔功能负担（治疗前3.5±1.33 vs. 治疗后0±0.86，p<0.0001）。11例（19%）患者在使用亚甲蓝口腔冲洗前已放置经皮内镜胃造瘘管，其中4例（36%）在冲洗后恢复经口进食；仍有2例（3%）尽管接受了亚甲蓝口腔冲洗仍需放置经皮内镜胃造瘘管。报告的轻微不良事件较少（n=9，15%）。我们的研究显示，亚甲蓝口腔冲洗是一种针对头颈癌放疗相关口腔黏膜炎所致阿片类药物难治性口腔疼痛的有效且安全的局部治疗方案。

原文链接：

Methylene Blue for the Treatment of Radiation-Induced Oral Mucositis during Head and Neck Cancer Treatment: An Uncontrolled Cohort