Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2020) – 128.41
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI – 0.22
Average rejection rate (2021) – 81.35%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

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Dental and Medical Problems

2012, vol. 49, nr 1, January-March, p. 69–77

Publication type: review article

Language: Polish

Zapalenie błony śluzowej jamy ustnej jako powikłanie w chemioterapii nowotworów

Oral Mucositis as Neoplasm Chemotherapy Complication

Beata Petkowicz1,, Izabela Jastrzębska1,, Rafał Jamrogiewicz1,

1 Samodzielna Pracownia Medycyny Jamy Ustnej, Uniwersytet Medyczny w L ublinie

Streszczenie

W ostatniej dekadzie liczba pacjentów dotkniętych chorobą nowotworową stale wzrasta. Ocenia się, że nawet co drugi leczony chemioterapią cierpi z powodu powikłań dających objawy w jamie ustnej. Zmiany te w znacznym stopniu obniżają komfort życia, mogą prowadzić do groźnych zakażeń ogólnoustrojowych oraz wydłużać czas i koszt leczenia. Patogeneza powikłań stomatologicznych u pacjentów onkologicznych jest związana z toksycznością chemioterapeutyków. Stosowanie tych specyficznych preparatów skutkuje rozwojem neutropenii, zmniejszeniem sekrecji śliny, a także szczególnie silnym działaniem na komórki ulegające podziałom. Z tych względów tkanki miękkie jamy ustnej są w sposób szczególny narażone na toksyczne działanie chemioterapeutyków. Objawy stomatologiczne pojawiające się podczas chemioterapii nie powinny być bagatelizowane, gdyż mogą być przyczyną poważnych powikłań, takich jak bakteriemie, nadkażenia grzybicze lub wirusowe. Bardzo istotna jest efektywna współpraca lekarza onkologa ze stomatologiem. Odpowiednia profilaktyka, przygotowanie stomatologiczne pacjenta oraz wczesne wykrycie zmian rozwijających się w jamie ustnej mogą w znacznym stopniu ograniczyć występowanie ciężkich powikłań stomatologicznych podczas chemioterapii. W pracy przedstawiono zagadnienia z zakresu epidemiologii, patogenezy, przebiegu, a także profilaktyki i leczenia zapaleń błony śluzowej jamy ustnej będących konsekwencją terapii nowotworów.

Abstract

According to many researchers in last ten years amount of patients with neoplasms significantly increased. It is estimated that even one out of two asked patients, complains about stomatological complications during antineoplastic treatment. Oral changes significantly decreases quality of life, lead to potentially serious systemic infectious complications and extends time and cost of care. The pathogenesis of this debilitating side effect can be attributed to the direct mucosal toxicity of cytotoxic agents which cause neutropenia, reduced saliva volume and direct influence on dividing cells. Dental symptoms which appear during chemotherapy should not be underestimated, as they may lead to serious complications such as bacteremia or fungal or viral superinfection. Cooperation between oncologist and dentist is essential. The appropriate prophylactics, proper stomatological preparation of patient as well as early recognition of developing pathoses in considerable degree can reduce occurrence of severe stomatological complications during chemotherapy. This article applies to issues of epidemiology, pathogenesis, course, prevention and treatment of oral mucositis that is a consequence of neoplasm therapy.

Słowa kluczowe

zapalenie błony śluzowej jamy ustnej, chemioterapia, nowotwór, powikłania, leczenie

Key words

oral mucositis, chemotherapy, neoplasm, complications, treatment

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