Sonis A L, Tarbell N, Valachovic R W, Gelber R, Schwenn M, Sallan S
Children's Hospital, Boston, MA 02115.
Cancer. 1990 Dec 15;66(12):2645-52. doi: 10.1002/1097-0142(19901215)66:12<2645::aid-cncr2820661230>3.0.co;2-s.
Ninety-seven children who were diagnosed with acute lymphoblastic leukemia before 10 years of age and treated with chemotherapy alone, chemotherapy plus 1800-cGy cranial irradiation (RT), or chemotherapy plus 2400-cGy RT were evaluated for effects of therapy on dentofacial development. All patients were seen at least 5 years postdiagnosis. Dental abnormalities were determined from panoramic radiographs, and craniofacial evaluations were made from lateral cephalometric radiographs. Ninety-one (94%) of all patients and 41 (100%) of patients younger than 5 years of age at diagnosis had abnormal dental development. The severity of these abnormalities was greater in children who received treatment before 5 years of age and in those who received RT. Observed dental abnormalities included tooth agenesis, arrested root development, microdontia, and enamel dysplasias. Craniofacial abnormalities occurred in 18 of 20 (90%) of those patients who received chemotherapy plus 2400-cGy RT before 5 years of age. Mean cephalometric values of this group showed significant deficient mandibular development. The results of this study suggest that the severity of dentofacial-developmental abnormalities secondary to antileukemia therapy are related to the age of the patient at the initiation of treatment and the use of cranial RT.
对97例10岁前被诊断为急性淋巴细胞白血病且仅接受化疗、化疗加1800厘戈瑞颅部放疗（RT）或化疗加2400厘戈瑞RT治疗的儿童，评估治疗对牙颌面发育的影响。所有患者均在诊断后至少5年接受检查。根据全景X线片确定牙齿异常情况，并根据头颅侧位X线片进行颅面部评估。所有患者中有91例（94%）以及诊断时年龄小于5岁的患者中有41例（100%）存在牙齿发育异常。这些异常在5岁前接受治疗的儿童以及接受RT治疗的儿童中更为严重。观察到的牙齿异常包括牙齿缺失、牙根发育停滞、过小牙和釉质发育不全。在5岁前接受化疗加2400厘戈瑞RT治疗的20例患者中有18例（90%）出现颅面部异常。该组的平均头影测量值显示下颌发育明显不足。本研究结果表明，抗白血病治疗继发的牙颌面发育异常的严重程度与治疗开始时患者的年龄以及颅部RT的使用有关。
