Section of Oral Medicine, MC1605, University of Connecticut Health, Farmington, CT, USA.
Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA.
Oral Dis. 2017 Nov;23(8):1134-1143. doi: 10.1111/odi.12710. Epub 2017 Aug 3.
To examine oral complications 6 months after modern radiation therapy (RT) for head and neck cancer (HNC).
Prospective multicenter cohort study of patients with HNC receiving intensity-modulated radiation therapy or more advanced RT. Stimulated whole salivary flow, maximal mouth opening, oral mucositis, oral pain, oral health-related quality of life (OH-QOL), and oral hygiene practices were measured in 372 subjects pre-RT and 216 subjects at 6 months from the start of RT.
Mean stimulated whole salivary flow declined from 1.09 to 0.47 ml/min at 6 months (p < .0001). Mean maximal mouth opening reduced from 45.58 to 42.53 mm at 6 months (p < .0001). 8.1% of subjects had some oral mucositis at 6 months, including 3.8% with oral ulceration. Mean overall pain score was unchanged. OH-QOL was reduced at 6 months, with changes related to dry mouth, sticky saliva, swallowing solid foods, and sense of taste (p ≤ .0001). At 6 months, there was greater frequency of using dental floss and greater proportion using supplemental fluoride (p < .0001).
Despite advances in RT techniques, patients with HNC experience oral complications 6 months after RT, with resulting negative impacts on oral function and quality of life.
检查头颈部癌症（HNC）患者接受现代放射治疗（RT）后 6 个月的口腔并发症。
对接受调强放疗或更先进 RT 的 HNC 患者进行前瞻性多中心队列研究。在 RT 开始前，对 372 名受试者和 216 名受试者进行了刺激全唾液流量、最大张口度、口腔黏膜炎、口腔疼痛、口腔健康相关生活质量（OH-QOL）和口腔卫生习惯的测量。
平均刺激全唾液流量从 RT 开始前的 1.09 降至 6 个月时的 0.47ml/min（p<0.0001）。平均最大张口度从 45.58 减少到 6 个月时的 42.53mm（p<0.0001）。8.1%的受试者在 6 个月时有口腔黏膜炎，其中 3.8%有口腔溃疡。平均整体疼痛评分无变化。OH-QOL 在 6 个月时降低，与口干、粘唾液、吞咽固体食物和味觉有关（p≤0.0001）。在 6 个月时，使用牙线的频率更高，使用补充氟化物的比例也更高（p<0.0001）。
尽管 RT 技术有所进步，但 HNC 患者在 RT 后 6 个月仍会出现口腔并发症，导致口腔功能和生活质量受到负面影响。
