Abstract: Radiation-induced oral mucositis（RIOM）is a common and severe complication of radiotherapy for head and neck cancers. Its pathogenesis involves multiple processes，including oxidative stress，inflammatory response，immune activation，and impaired epithelial repair. Currently，clinical interventions for RIOM have limited efficacy，and there is a lack of specific therapeutic drugs targeting the underlying pathological mechanisms. In recent years，the intervention strategies for RIOM with small-molecule targeted drugs as the core have gradually become a research focus. This article systematically reviews small-molecule targeted drugs acting across various pathological stages of RIOM，including superoxide dismutase mimetics and nuclear factor erythroid 2-related factor 2（Nrf2）modulators that target oxidative stress，innate defense regulators that modulate innate immunity，nuclear factor κB（NF-κB）inhibitors that suppress key inflammatory pathway，and uridine phosphorylase inhibitors that promote mucosal epithelial repair，elaborating on their mechanisms of action，summarizing the preclinical and clinical research progress，and analyzing key challenges in current drug development. Furthermore，it looks forward to the future directions of development in multi-target combination therapies，aiming to provide theoretical evidence and strategic support for the precise prevention and management of RIOM.

Key words: radiation-induced oral mucositis, small-molecule targeted drugs, oxidative stress, inflammatory response, clinical trials

摘要： 放射性口腔黏膜炎（radiation-induced oral mucositis，RIOM）是头颈部肿瘤放疗过程中常见且严重的并发症，其发病机制涉及氧化应激、炎症反应、免疫激活及上皮修复障碍等多个环节。目前RIOM的临床干预手段有限，缺乏针对其病理机制的特异性治疗药物。近年来，以小分子靶向药物为核心的RIOM干预策略逐渐成为研究热点。文章针对RIOM不同病理阶段的小分子靶向药物[包括靶向氧化应激的超氧化物歧化酶模拟物和核因子红细胞2相关因子2（nuclear factor erythroid 2-related factor 2，Nrf2）调节剂、调控固有免疫应答的先天防御调节剂、抑制关键炎症通路的核因子κB（nuclear factor κB，NF-κB）抑制剂及促进黏膜上皮修复的尿苷磷酸化酶抑制剂等]进行系统综述，阐述相应药物的作用机制，总结其临床前及临床研究进展，并分析当前研发过程中面临的关键挑战，展望未来多靶点联合用药等的发展方向，以期为RIOM的精准防治提供理论依据和策略支持。

关键词: 放射性口腔黏膜炎, 小分子靶向药物, 氧化应激, 炎症反应, 临床试验