PDF(Pubmed)
Abstract：
OBJECTIVE: A MASCC/ISOO Clinical Practice Statement (CPS) is aimed at generating a concise tool for clinicians that concentrates practical information needed for the management of oral complications of cancer patients. This CPS is focused on the risk of secondary oral cancer following hematopoietic cell transplantation (HCT).
METHODS: This CPS was developed based on critical evaluation of the literature followed by a structured discussion of a group of leading experts, members of the Oral Care Study Group of MASCC/ISOO. The information is presented in the form of succinct bullets to generate a short manual about the best standard of care.
RESULTS: Studies described a 7-16-fold higher risk of secondary oral cancer (mainly squamous cell carcinoma) in allogeneic HCT (alloHCT) recipients, particularly in those who developed chronic graft versus host disease (cGVHD). Risk increases over time and is influenced by several risk factors. In autologous HCT, oral cancer risk seemed only slightly elevated.
CONCLUSIONS: Clinicians should be aware of the higher oral cancer risk in alloHCT survivors, and emphasize the importance of lifelong oral cancer surveillance (at least every 6-12 months) and avoiding cancer promoting lifestyle factors in an empathic way, particularly of those with (a history of) cGVHD. Post-HCT for Fanconi anemia or dyskeratosis congenita, education and rigorous follow-up is even more crucial. In case of suspected oral lesions in the presence of oral mucosal cGVHD, a GVHD intervention may facilitate diagnosis. Suspected lesions should be biopsied. More research is needed on the role of HPV in oral cancer post-HCT.
METHODS: This CPS was developed based on critical evaluation of the literature followed by a structured discussion of a group of leading experts, members of the Oral Care Study Group of MASCC/ISOO. The information is presented in the form of succinct bullets to generate a short manual about the best standard of care.
RESULTS: Studies described a 7-16-fold higher risk of secondary oral cancer (mainly squamous cell carcinoma) in allogeneic HCT (alloHCT) recipients, particularly in those who developed chronic graft versus host disease (cGVHD). Risk increases over time and is influenced by several risk factors. In autologous HCT, oral cancer risk seemed only slightly elevated.
CONCLUSIONS: Clinicians should be aware of the higher oral cancer risk in alloHCT survivors, and emphasize the importance of lifelong oral cancer surveillance (at least every 6-12 months) and avoiding cancer promoting lifestyle factors in an empathic way, particularly of those with (a history of) cGVHD. Post-HCT for Fanconi anemia or dyskeratosis congenita, education and rigorous follow-up is even more crucial. In case of suspected oral lesions in the presence of oral mucosal cGVHD, a GVHD intervention may facilitate diagnosis. Suspected lesions should be biopsied. More research is needed on the role of HPV in oral cancer post-HCT.
摘要：
目的：MASCC/ISOO临床实践声明（CPS）旨在为临床医生提供一个简洁的工具，集中治疗癌症患者口腔并发症所需的实用信息。该CPS关注造血细胞移植（HCT）后继发性口腔癌的风险。
方法：本CPS是在对文献进行批判性评估的基础上开发的，随后是一组领先专家的结构化讨论。MASCC/ISOO口腔护理研究小组的成员。该信息以简洁的子弹形式呈现，以生成有关最佳护理标准的简短手册。
结果：研究表明，同种异体HCT（alloHCT）受者发生继发性口腔癌（主要是鳞状细胞癌）的风险高7-16倍，尤其是那些发展为慢性移植物抗宿主病（cGVHD）的患者。风险随着时间的推移而增加，并受到几个风险因素的影响。在自体HCT中，口腔癌的风险似乎只是略有升高。
结论：临床医生应该意识到alloHCT幸存者患口腔癌的风险更高，并强调终身口腔癌监测（至少每6-12个月）的重要性，并以移情方式避免癌症促进生活方式因素，特别是那些有(有)cGVHD历史的人。Fanconi贫血或先天性角化障碍的HCT后，教育和严格的后续行动更为重要。如果在存在口腔粘膜cGVHD的情况下怀疑口腔病变，GVHD干预可能有助于诊断.可疑病变应进行活检。需要更多关于HPV在HCT后口腔癌中的作用的研究。
方法：本CPS是在对文献进行批判性评估的基础上开发的，随后是一组领先专家的结构化讨论。MASCC/ISOO口腔护理研究小组的成员。该信息以简洁的子弹形式呈现，以生成有关最佳护理标准的简短手册。
结果：研究表明，同种异体HCT（alloHCT）受者发生继发性口腔癌（主要是鳞状细胞癌）的风险高7-16倍，尤其是那些发展为慢性移植物抗宿主病（cGVHD）的患者。风险随着时间的推移而增加，并受到几个风险因素的影响。在自体HCT中，口腔癌的风险似乎只是略有升高。
结论：临床医生应该意识到alloHCT幸存者患口腔癌的风险更高，并强调终身口腔癌监测（至少每6-12个月）的重要性，并以移情方式避免癌症促进生活方式因素，特别是那些有(有)cGVHD历史的人。Fanconi贫血或先天性角化障碍的HCT后，教育和严格的后续行动更为重要。如果在存在口腔粘膜cGVHD的情况下怀疑口腔病变，GVHD干预可能有助于诊断.可疑病变应进行活检。需要更多关于HPV在HCT后口腔癌中的作用的研究。
