疼痛是头颈癌 (HNC) 放射治疗 (RT) 后最常见的急性症状。放疗引起的疼痛具有多因素根源，因此治疗起来极具挑战性。进行了多项研究来确定与癌症疼痛相关的遗传变异，但很少有研究关注放疗引起的急性疼痛。在这篇综述中，我们总结了 HNC 放疗后急性疼痛的潜在机制，并确定了与放疗引起的急性疼痛和相关急性毒性相关的遗传变异。使​​用包括“变异”在内的术语对 Ovid Medline、EMBASE 和 Web of Science 数据库进行了全面搜索》、《多态性》、《放射治疗》、《急性疼痛》、《急性毒性》发表截至2022年2月28日，由两位审稿人完成。评论文章和引文均经过人工审核。报告了与放疗引起的急性疼痛和毒性相关的已鉴定的 SNP，并使用人类基因数据库基于遗传注释描述了相关基因的分子功能； GeneCards.电子检索共检索到386篇文章，手工检索后又收录了8篇文章。最终收录21篇文章。 27个基因的32个变异，其中25%与炎症/免疫反应有关，20%在DNA损伤反应和修复中具有功能，20%与细胞死亡或细胞周期有关，与RT炎性疼痛和急性口腔粘膜炎或皮炎相关。 4 个基因的 4 个变异与神经病和神经性疼痛相关。 4 个基因中的 5 个变异与放疗引起的放疗后喉咙/颈部疼痛的混合类型相关。HNC 中放疗后出现不同类型的疼痛，包括炎性疼痛；神经性疼痛;伤害性疼痛；以及混合性口腔疼痛。涉及 DNA 损伤反应和修复、细胞死亡、炎症和神经病理通路的遗传变异可能会影响放疗后的疼痛表现。这些变体可用于接受 RT 的 HNC 患者的个性化疼痛管理。© 2023 作者。

Pain is the most common acute symptom following radiation therapy (RT) for head and neck cancer (HNC). The multifactorial origin of RT-induced pain makes it highly challenging to manage. Multiple studies were conducted to identify genetic variants associated with cancer pain, however few of them focused on RT-induced acute pain. In this review, we summarize the potential mechanisms of acute pain after RT in HNC and identify genetic variants associated with RT-induced acute pain and relevant acute toxicities.A comprehensive search of Ovid Medline, EMBASE and Web of Science databases using terms including "Variants", "Polymorphisms", "Radiotherapy", "Acute pain", "Acute toxicity" published up to February 28, 2022, was performed by two reviewers. Review articles and citations were reviewed manually. The identified SNPs associated with RT-induced acute pain and toxicities were reported, and the molecular functions of the associated genes were described based on genetic annotation using The Human Gene Database; GeneCards.A total of 386 articles were identified electronically and 8 more articles were included after manual search. 21 articles were finally included. 32 variants in 27 genes, of which 25% in inflammatory/immune response, 20% had function in DNA damage response and repair, 20% in cell death or cell cycle, were associated with RT-inflammatory pain and acute oral mucositis or dermatitis. 4 variants in 4 genes were associated with neuropathy and neuropathic pain. 5 variants in 4 genes were associated with RT-induced mixed types of post-RT-throat/neck pain.Different types of pain develop after RT in HNC, including inflammatory pain; neuropathic pain; nociceptive pain; and mixed oral pain. Genetic variants involved in DNA damage response and repair, cell death, inflammation and neuropathic pathways may affect pain presentation post-RT. These variants could be used for personalized pain management in HNC patients receiving RT.© 2023 The Author(s).