Aggarwal Karun, Goutam Manish, Singh Madhavi, Kharat Neetu, Singh Vandana, Vyas Suyash, Singh Harkanwal Preet
Department of Oral and Maxillofacial Surgery, Jodhpur Dental College and Hospital, Jodhpur, Rajasthan, India.
Dentica Oral Care and Implant Centre, Ranchi, Jharkhand, India.
Niger J Surg. 2017 Jul-Dec;23(2):130-133. doi: 10.4103/njs.NJS_40_16.
In head and neck cancer patients undergoing radiotherapy, osteoradionecrosis (ORN) of the jaw is one of the major but uncommon complications. Satisfactorily results have been observed while treating ORN patients with upcoming treatment modalities such as combination therapy of pentoxifylline and Vitamin E (PVe). It is believed that in patients undergoing dental extractions, these treatment modalities can be used prophylactically for lowering the risk of development of ORN. Hence, keeping all these things in mind, we planned the present study to assess the prophylactic role of pentoxifylline and tocopherol in patients who require dental extractions after radiotherapy for cancer of head and neck.
A total of 110 patients were included in this retrospective study, which had radiotherapy for cancer of the head and neck. After radiotherapy, a total of 450 dental extractions were done in these 110 patients.
External beam therapy was given in 92.72% of the patients. 7.27% and 40% of the patients received intensity modulated radiotherapy combination of chemotherapy and intensity modulated radiotherapy, respectively. ORN developed only in 2 patients. Patients had taken PVe for a mean of 12 (24) weeks preoperatively and 14 (18) weeks postoperatively. The incidence was lower than that normally associated with dental extractions in irradiated patients.
In patients undergoing dental extractions, after receiving radiotherapy of head and neck region, combination therapy of pentoxifylline and tocopherol are sufficiently effective.
在接受放射治疗的头颈癌患者中,颌骨放射性骨坏死(ORN)是一种主要但不常见的并发症。使用诸如己酮可可碱和维生素E联合治疗(PVe)等新出现的治疗方式治疗ORN患者时,已观察到令人满意的效果。据信,在接受拔牙的患者中,这些治疗方式可用于预防性降低ORN发生的风险。因此,考虑到所有这些因素,我们开展了本研究,以评估己酮可可碱和生育酚在头颈部癌症放疗后需要拔牙的患者中的预防作用。
本回顾性研究共纳入110名头颈部癌症放疗患者。放疗后,这110名患者共进行了450次拔牙。
92.72%的患者接受了外照射治疗。分别有7.27%和40%的患者接受了调强放疗、化疗与调强放疗联合治疗。仅2名患者发生了ORN。患者术前平均服用PVe 12(24)周,术后平均服用14(18)周。该发生率低于接受放疗患者拔牙通常相关的发生率。
在接受头颈部放疗后拔牙的患者中,己酮可可碱和生育酚联合治疗足够有效。