University of Pennsylvania Health System, Department of Oral and Maxillofacial Surgery, Perelman Center for Advanced Medicine, South Pavilion, 4th Floor, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United States.
New York-Presbyterian Hospital, Columbia University Medical Center, Division of Oral and Maxillofacial Surgery, 630 W 168th St, New York, NY 10032, United States.
Oral Oncol. 2018 Jan;76:42-51. doi: 10.1016/j.oraloncology.2017.11.023. Epub 2017 Dec 6.
Treatment of head and neck cancer (HNC) is accompanied by a high rate of morbidity, and complications can have a lifelong, profound impact on both patients and caregivers. Radiation-related injury to the hard and soft tissue of the head and neck can significantly decrease patients' quality of life. The purpose of this study is to provide patent-specific guidelines for managing the oral health and related side effects of HNC patients treated with radiation therapy. Based on reviewed articles retrieved on the PubMed database, guidelines for management of the oral health of this patient population were organized into three separate categories: cancer, patient, and dentition. The location, type, and staging of the cancer, along with the radiation used to treat the cancer significantly impact dental treatment. Several unique patient characteristics such as motivation, presence of support system, socioeconomic status, nutrition, and race have all been found to affect outcomes. Dental disease and available supportive dental management was found to significantly impact treatment and quality of life in this patient population. By comprehensively assessing unique cancer, patient, and dental-related factors, this review provides individualized evidence-based guidelines on the proper management of this complex and vulnerable patient population.
治疗头颈部癌症（HNC）伴随着高发病率，并发症会对患者和护理人员产生终身的深远影响。头颈部软硬组织的放射性损伤会显著降低患者的生活质量。本研究的目的是为接受放射治疗的 HNC 患者提供针对特定患者的口腔健康管理和相关副作用的指导方针。本研究基于在 PubMed 数据库中检索到的文章，将针对该患者人群口腔健康管理的指南分为癌症、患者和牙列三个单独的类别。癌症的位置、类型和分期，以及用于治疗癌症的放射治疗，都会对牙科治疗产生重大影响。一些独特的患者特征，如动机、支持系统的存在、社会经济地位、营养和种族，都被发现会影响治疗效果。已发现口腔疾病和可用的支持性牙科管理会显著影响该患者人群的治疗和生活质量。通过全面评估独特的癌症、患者和与牙齿相关的因素，本综述为这一复杂且脆弱的患者人群提供了个性化的基于循证的管理指南。
