肿瘤患者诊疗全程中的口腔管理：临床方案的范围综述

Oral complications of cancer and its therapies impair quality of life and can disrupt oncologic care. Standardizing dental management across the care pathway is essential.

To map operational protocols, guidelines, algorithms, or structured recommendations for dental management of oncology patients across pre-treatment, active treatment, and follow-up or survivorship from 2000 to 2025. MATERIAL AND METHODS: Scoping review according to JBI guidance and reported with PRISMA-ScR. Searches were run in PubMed or MEDLINE, SciELO, Scopus, Web of Science, and the Virtual Health Library on October 19, 2025, without language restrictions. Dual screening was performed in Rayyan. Data were charted in a standardized per-record matrix and synthesized narratively, in tables, and with graphics by care phase and oncologic modality. No formal critical appraisal or meta-analysis was undertaken.

Twelve records were included. Coverage concentrated on pre-treatment (11 of 12; 91.7 percent), followed by follow-up or survivorship (6 of 12; 50.0 percent) and active treatment (3 of 12; 25.0 percent). Convergent recommendations included comprehensive pre-treatment assessment with sanitation, an intensified prevention bundle with hygiene instruction and topical fluorides, tooth-prognosis-based extraction criteria with defined healing windows, and supportive measures during therapy for mucositis, xerostomia, and infections. Gaps included limited standardization of survivorship pathways, insufficient personalization by oncologic modality (radiotherapy, chemotherapy, HSCT or CAR-T, immunotherapies), and scarce operational detail on safe timing windows, clinical or hematologic cutoffs, and referral or consultation triggers.

Evidence supports an operational consensus for pre-treatment clearance and a core supportive bundle during therapy. To optimize safety and outcomes, particularly in middle-income settings, modality-specific protocols with explicit dentistry-oncology referral pathways, dose- and hematology-informed decision rules, and defined follow-up schedules are warranted.