口腔疾病防治2026，Vol.34Issue(4)：385-394,10.DOI:10.12016/j.issn.2096-1456.202550349
头颈肿瘤放疗后口腔微生态失调及其干预策略的研究进展
Research progress on oral microecological imbalance and intervention strategies after radiotherapy for head and neck tumors
摘要
Abstract
Radiotherapy is a crucial treatment modality for head and neck tumors.However,while effectively killing tumor cells,it significantly disrupts the homeostasis of the oral microecology,which is closely associated with various complications such as radiation-induced oral mucositis.Literature review indicates that as radiotherapy doses accumu-late and treatment durations extend,the richness and diversity of the oral microbiota show a declining trend,with the genus Streptococcus decreasing most markedly.In contrast,radiotherapy selectively promotes the proliferation of bacte-rial phyla such as Proteobacteria and Bacteroidetes,which are rich in opportunistic pathogens.Mechanistically,radio-therapy activates the nuclear factor-kappa B pathway,triggering chronic inflammation and oxidative stress,damaging the epithelial barrier,suppressing local immunity,and causing damage to organs such as the salivary glands.It can also induce systemic diseases via the oral-gut axis,forming a multi-level,interconnected pathogenic network.In terms of in-terventions,treatment strategies including probiotics and prebiotics have shown promising efficacy against side effects such as radiation-induced oral mucositis.Saliva-based oral microbiota transplantation is an emerging strategy that is ex-pected to become widely utilized for restoring oral microecological balance.Existing interventions provide preliminary pathways for clinical practice,but this field still faces several key scientific questions.The association between oral mi-croecology and systemic diseases remains largely correlative,lacking causal evidence.Furthermore,critical parameters for oral microbiota transplantation,such as donor screening criteria,transplantation protocols,and long-term safety,are not yet well-defined.Therefore,future research should focus on conducting large-scale clinical trials to establish stan-dardized protocols and safety evaluation systems for oral microecological interventions,and explore combined treatment therapies such as probiotics,prebiotics,and microbiota transplantation to advance the development of personalized pre-cision modulation.These will enable more effective management of radiotherapy-induced oral microecological dysbiosis and improve treatment outcomes and quality of life for patients with head and neck tumors.关键词
头颈肿瘤/放射治疗/放射性口腔黏膜病/口腔微生态/菌群失调/益生菌/益生元/菌群移植/口腔菌群/精准调控Key words
head and neck tumor/radiotherapy/radiation-induced oral mucosal disease/oral microecologi-cal/microecology imbalance/probiotics/prebiotics/microbiota transplantation/oral microbiota/precision modulation分类
医药卫生引用本文复制引用
刘雪,李雨霏,杨薪瑶,李好,张爱琳,崔蕾,黄正蔚,侯黎莉..头颈肿瘤放疗后口腔微生态失调及其干预策略的研究进展[J].口腔疾病防治,2026,34(4):385-394,10.基金项目
国家自然科学基金项目(82071104) （82071104）
上海市重中之重研究中心(2022ZZ01017) （2022ZZ01017）
上海市"科技创新行动计划"长三角科技创新共同体领域项目(21002411300) （21002411300）
中国医学科学院医学与健康科技创新工程项目(2019-I2M-5-037) This study was supported by the grants from the National Natural Science Foundation of China(No.82071104) （2019-I2M-5-037）
Shang-hai's Top Priority Research Center(No.2022ZZ01017) （No.2022ZZ01017）
the Yangtze River Delta Science and Technology Innovation Community Project of the"Science and Technology Innovation Action Plan"in Shanghai(No.21002411300) （No.21002411300）
Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(No.2019-I2M-5-037). （No.2019-I2M-5-037）
