This review systematically examines the oral complications associated with conventional and novel anti-cancer therapies. It highlights that while molecularly targeted agents including monoclonal antibodies targeting the vascular endothelial growth factor and its receptor, the epidermal growth factor receptor, tyrosine kinase inhibitors, and immune checkpoint inhibitors tend to exhibit a lower overall toxicity profile compared to traditional cytotoxic chemotherapeutics, they are nonetheless linked to significant oral adverse events. These complications encompass inflammatory mucosal reactions known as mucositis, salivary gland dysfunction leading to a sensation of dryness in the mouth, taste alterations referred to as dysgeusia, and, critically, medication-related osteonecrosis of the jaw. In particular, bone-modifying agents such as bisphosphonates and denosumab disrupt bone remodeling and the formation of new blood vessels, thereby increasing the susceptibility to osteonecrosis of the jaw, especially following invasive dental procedures. The review delineates the multifactorial pathogenesis underlying these toxicities, which involves direct cell toxicity, impaired wound healing, and secondary infections. Furthermore, it emphasizes the importance of pre-treatment dental evaluation and preventive strategies including patient education, prophylactic dental care, and the integration of adjunctive therapies such as laser therapy and autologous platelet concentrates to mitigate these adverse effects. The analysis advocates for interdisciplinary collaboration between oncologists and dental professionals to optimize management protocols, enhance treatment adherence, and ultimately improve the quality of life for oncology patients undergoing anti-cancer therapy.
本综述系统探讨了传统与新型抗癌疗法相关的口腔并发症。文章指出，尽管以血管内皮生长因子及其受体、表皮生长因子受体为靶点的单克隆抗体、酪氨酸激酶抑制剂以及免疫检查点抑制剂等分子靶向药物相较于传统细胞毒性化疗药物总体毒性较低，但仍与显著的口腔不良事件相关。这些并发症包括被称为黏膜炎的炎症性黏膜反应、导致口腔干燥感的唾液腺功能障碍、味觉改变（即味觉障碍），以及尤为关键的药物相关性颌骨坏死。特别是双膦酸盐和地诺单抗等骨改良药物会干扰骨重塑及新生血管形成，从而增加颌骨坏死的易感性，尤其是在有创牙科操作后。综述阐明了这些毒性反应的多因素发病机制，涉及直接细胞毒性、伤口愈合障碍及继发感染。此外，文章强调治疗前口腔评估及预防策略的重要性，包括患者教育、预防性牙科护理，以及结合激光治疗和自体血小板浓缩物等辅助疗法以减轻这些不良反应。分析主张肿瘤科医师与口腔专业人员的跨学科协作，以优化管理方案、提高治疗依从性，最终改善接受抗癌治疗的肿瘤患者的生活质量。
Navigating Stomatologic Complications Secondary to Antineoplastic Agents—A Comprehensive Review
肿瘤(癌症)患者之家