Department of Surgical Oncology, National Institute for Cancer Research IST, Genoa, Italy.
In Vivo. 2010 Nov-Dec;24(6):889-93.
Osteoradionecrosis (ORN) of the mandible is a major complication of radiation therapy of head and neck cancer with a potential of occurrence ranging from 5 to 15% of the irradiated patients. Due to the gradual necrotic process, the mandibular bone becomes necrotic and looses its spontaneous regeneration ability. Containing an elevated content of mitogenic and osteogenic growth factors, the use of platelet rich plasma (PRP) from autologous source has been suggested to re-activate the healing process of osteogenesis. Autologous PRP gel was introduced into the ORN necrotic defect of a 44-year old patient previously treated for squamous cell carcinoma of the tongue, subsequent to proper surgical debridement. We report post-operative two-year follow-up demonstrated by panoramic X-ray which showed regain of the mandibular bone continuity with a complete repair of the necrotic defects. We conclude that this case illustrates an incident of successful regeneration of ORN critical-sized defect of the mandible by autologous PRP gel.
下颌骨放射性骨坏死(ORN)是头颈部癌症放射治疗的主要并发症,其发生率在接受放射治疗的患者中为 5%至 15%。由于坏死过程是逐渐发生的,下颌骨会发生坏死,丧失其自发再生的能力。富含促有丝分裂和成骨生长因子的富血小板血浆(PRP)的应用,被认为可以重新激活成骨愈合过程。我们将自体 PRP 凝胶引入到一位 44 岁患者的 ORN 坏死缺损处,该患者曾因舌部鳞状细胞癌接受过适当的外科清创术。术后两年的全景 X 线随访显示,下颌骨连续性恢复,坏死缺损完全修复。我们得出结论,该病例说明了通过自体 PRP 凝胶成功再生下颌骨临界尺寸 ORN 缺损的情况。