(1) Background: Immunotherapy-related adverse effects (irAEs) have been reported to manifest in oral tissues, mainly as lichenoid and non-lichenoid lesions and salivary gland dysfunction; however, the characterization of oral irAEs and their clinical impact is limited. (2) Methods: This is a retrospective clinical chart review of 14 patients with oral irAEs, describing the impact of the oral irAEs in terms of the immediate effect, treatment, chronicity of the irAEs and the development of oral cancer. (3) Results: Common symptoms were pain and dry mouth, causing no-to-severe pain and/or dry mouth sensation. The immediate sequala ranged from sensitivity to certain foods up to elimination of oral intake. Treatment included conventional palliation techniques with or without systemic steroids. Discontinuation of the immunotherapy agents was required in 6 patients. Innovative treatment modalities included photobiomodulation for oral mucosal pain relief, and salivary gland intraductal irrigations for relief of salivary gland hypofunction. Late sequala included the development of proliferative leukoplakia and oral cancer. (4) Conclusions: Patients treated with immunotherapy may develop debilitating oral irAEs. They should be followed for oral involvement so treatment may be initiated when the symptoms are mild to avoid discontinuation of the immunotherapy. Patients that develop oral lichenoid lesions should receive long-term follow-up, as they may have higher risk for oral cancer.
（1）背景：已有报道显示免疫治疗相关不良反应（irAEs）可发生于口腔组织，主要表现为苔藓样与非苔藓样病损以及唾液腺功能障碍，但目前对口腔irAEs的特征及其临床影响的认识仍有限。（2）方法：本研究对14例口腔irAEs患者进行回顾性临床病历分析，从即时影响、治疗措施、irAEs的慢性化趋势及口腔癌发生情况等方面描述口腔irAEs的临床影响。（3）结果：常见症状为疼痛与口干，可表现为无痛至剧烈疼痛和/或不同程度口干。即时后遗症包括对特定食物敏感至完全无法经口进食。治疗手段包括常规姑息疗法联合或不联合全身性类固醇，其中6例患者需停用免疫治疗药物。创新性治疗方式包括采用光生物调节缓解口腔黏膜疼痛，以及唾液腺导管内灌洗改善唾液腺功能减退。远期后遗症包括增生性白斑及口腔癌的发生。（4）结论：接受免疫治疗的患者可能出现严重影响生活质量的口腔irAEs。应对患者进行口腔病变监测，以便在症状轻微时及时干预，避免中断免疫治疗。发生口腔苔藓样病变的患者需接受长期随访，因其可能具有更高的口腔癌风险。
Immunotherapy-Related Oral Adverse Effects: Immediate Sequelae, Chronicity and Secondary Cancer
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