Kasetty Sowmya, Khan Samar, Shridhar Sudheendra U, Gupta Sandeep, Tijare Manisha, Kallianpur Shreenivas, Raju Ragavendra T
Department of Oral Pathology, Peoples College of Dental Sciences and Research Centre, Bhopal-462037, MadhyaPradesh, India.
World J Oncol. 2012 Oct;3(5):205-209. doi: 10.4021/wjon581e. Epub 2012 Oct 28.
Cancer diagnosis coupled with emotional impact converge to create one of the most difficult physical and emotional periods of life. Cancer treatment causes plethora of short and long term complications which can be so debilitating that patient may interrupt treatment. Pretreatment oral assessment and supportive oral care during and after cancer therapy can increase quality of life and supportive care costs.
Study was conducted on 189 patients (86: head and neck cancer cases, group I and 103: other than head and neck cancer cases, group II) receiving cancer therapy. Patients were subjected to clinical assessment and findings were recorded in specially designed proforma and complete oral (objective and subjective) and constitutional findings were recorded.
Among the patients undergoing chemotherapy in both groups, prevalence of oral findings was found to be highest with methotrexate whereas constitutional symptoms was found to be highest with doxyrubicin. Whereas in radiotherapy patients subjective and objective oral symptoms increased from 10th - 30th fractionated dose of radiations and then subsequently decreased and constitutional symptoms were found to be consistent in all fractionated dosages with lowest at 50th fraction. Under combined chemo and radiotherapy patients, constitutional symptoms were highest than the oral findings.
Cancer therapy can greatly damage the normal tissues and diminish patients quality of life and often leads to serious clinical sequelae. Therefore, therapy induced damage should be anticipated and prevented whenever possible and managed early.
癌症诊断及其带来的情感冲击共同构成了人生中最艰难的身体和情感阶段之一。癌症治疗会引发大量短期和长期并发症,这些并发症可能极为虚弱,以至于患者可能中断治疗。癌症治疗前的口腔评估以及治疗期间和之后的支持性口腔护理可提高生活质量并降低支持性护理成本。
对189例接受癌症治疗的患者进行了研究(86例:头颈癌患者,第一组;103例:非头颈癌患者,第二组)。对患者进行临床评估,并将结果记录在专门设计的表格中,同时记录完整的口腔(客观和主观)及全身检查结果。
在两组接受化疗的患者中,发现甲氨蝶呤导致的口腔问题发生率最高,而阿霉素导致的全身症状发生率最高。在接受放疗的患者中,主观和客观口腔症状在第10 - 30次分次放疗剂量时增加,随后下降,而全身症状在所有分次剂量中保持一致,在第50次分次剂量时最低。在联合化疗和放疗的患者中全身症状比口腔问题更严重。
癌症治疗会极大地损害正常组织,降低患者生活质量,并常常导致严重的临床后遗症。因此,应尽可能预见并预防治疗引起的损害,并尽早进行处理。