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OA

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.