放疗诱发的头颈癌治疗期间的口腔黏膜炎症疼痛，常常因化疗的配合而加重，并且通常无法有效缓解传统治疗。为了探索安全且可持续的替代方案，我们对亚甲蓝口腔漱洗液在减轻放疗相关口腔黏膜炎症疼痛中的作用进行了研究。我们在一个三级诊疗学术型癌症中心进行了一项回顾性观察性队列研究，纳入了85名头颈癌放疗期间口腔黏膜炎症疼痛难治的患者。测量了疼痛程度（0-10分制）、口腔功能负担（0-6分制）和经皮内镜下胃造瘘导管插入的需求。其中58名患者中，60%接受了单纯放疗，40%接受了化疗和放疗的联合治疗。亚甲蓝口腔漱洗液（MBOR）显著降低了口腔黏膜炎症疼痛持续时间至少6.2小时（中位数+标准差，8 ± 1.68比之前下降至2 ± 2.20；p < 0.0001），口腔功能负担（3.5 ± 1.33比之前下降至0 ± 0.86；p < 0.0001）。11名患者（19%）在使用亚甲蓝口腔漱洗液之前插入了经皮内镜下胃造瘘导管，在使用亚甲蓝口腔漱洗液后，其中4名患者（36%）恢复了口腔摄食。2名患者（3%）在使用亚甲蓝口腔漱洗液后仍然需要经皮内镜下胃造瘘导管。报告了少量的不良事件（n = 9，15%）。我们的研究显示，亚甲蓝口腔漱洗液是一种有效且安全的局部治疗方法，可用于缓解因放疗导致的头颈癌口腔黏膜炎症相关的疼痛，而且适用于阿片类药物难治的情况。

Pain from radiation-therapy-induced oral mucositis during head-neck cancer treatment is aggravated by concurrent chemotherapy and commonly fails traditional treatments. To explore safe and sustainable alternatives, we investigated methylene blue oral rinse to reduce radiation-therapy-related oral mucositis pain. For this, we conducted a retrospective observational cohort study in a tertiary-care academic care cancer center including 85 patients with refractory oral mucositis pain during radiation therapy for head-neck cancer. Changes in pain (scale 0-10), oral function burden (scale 0-6) and requirement for percutaneous endoscopic gastrostomy tube placement were measured. Among 58 patients, 60% received radiation therapy alone and 40% received concurrent chemotherapy-radiation therapy. Methylene blue oral rinse (MBOR) significantly decreased oral mucositis pain for at least 6.2 h (median + SD 8 ± 1.68 before vs. 2 ± 2.20 after; p < 0.0001) and oral function burden (3.5 ± 1.33 before vs. 0 ± 0.86 after; p < 0.0001). Eleven patients (19%) had percutaneous endoscopic gastrostomy tubes placed before using methylene blue oral rinse; subsequently, four (36%) resumed oral alimentation after methylene blue oral rinse. Two patients (3%) required percutaneous endoscopic gastrostomy tubes despite methylene blue oral rinse. Minimal adverse events were reported (n = 9, 15%). Our study showed that methylene blue oral rinse was an effective and safe topical treatment for opioid-refractory oral pain from oral mucositis associated with radiation therapy for head-neck cancer.