Pereira I-F, Firmino R-T, Meira H-C, Vasconcelos B-C-E, Noronha V-R-A-S, Santos V-R
School of Dentistry, Federal University of Minas Gerais, Department of Clinical, Pathology and Surgery, Presidente Antônio Carlos, 6627 - 31270-901- Pampulha Belo Horizonte - MG, Brazil,
Med Oral Patol Oral Cir Bucal. 2018 Nov 1;23(6):e633-e638. doi: 10.4317/medoral.22310.
Osteoradionecrosis (ORN) is one of the most serious complications of head and neck radiotherapy and is considered a public health problem worldwide. This study aims to determine the prevalence and associated factors of ORN in patients undergoing radiotherapy for head and neck malignancy.
A cross-sectional retrospective study was conducted, in which all medical records of patients undergoing head and neck radiation in the period between 2006 to 2015 (10 years) were examined. Clinical and demographic data were extracted. Multivariate Poisson regression analysis with robust variance was employed to access the relationship between ORN and independent variables (p < 0.05; 95% CI).
The sample comprised 413 medical records of patients undergoing radiotherapy. The prevalence of ORN was 9.7 %. Most participants were males (78.2%). The mean age of subjects was 55 years (± 14 years). The mandible was the main site of occurrence of ORN (85.0%). The following variables were associated with ORN : presence of oral mucositis (PR = 3.03; 95% CI: 1.30-7.03), history of smoking (PR = 0.23; 95% CI: 0.07-0.74), number of teeth removed before radiotherapy (PR = 1.06; 95% CI: 1.01-1.11) and visit to the dentist before radiation (PR = 0.08; 95% CI: 1.02-1.11).
The prevalence of ORN was low and was associated with the presence of oral mucositis and the number of removed teeth before radiation. Visiting the dentist before radiotherapy and stop-ping smoking were protective factors for ORN.
放射性骨坏死(ORN)是头颈部放疗最严重的并发症之一,被认为是全球范围内的一个公共卫生问题。本研究旨在确定头颈部恶性肿瘤放疗患者中ORN的患病率及相关因素。
进行了一项横断面回顾性研究,检查了2006年至2015年(10年)期间接受头颈部放疗患者的所有病历。提取了临床和人口统计学数据。采用具有稳健方差的多变量泊松回归分析来探讨ORN与自变量之间的关系(p<0.05;95%置信区间)。
样本包括413例接受放疗患者的病历。ORN的患病率为9.7%。大多数参与者为男性(78.2%)。受试者的平均年龄为55岁(±14岁)。下颌骨是ORN的主要发生部位(85.0%)。以下变量与ORN相关:口腔黏膜炎的存在(PR=3.03;95%置信区间:1.30 - 7.03)、吸烟史(PR=0.23;95%置信区间:0.07 - 0.74)、放疗前拔牙数量(PR=1.06;95%置信区间:1.01 - 1.11)以及放疗前看牙医(PR=0.08;95%置信区间:1.02 - 1.11)。
ORN的患病率较低,与口腔黏膜炎的存在以及放疗前拔牙数量有关。放疗前看牙医和戒烟是ORN的保护因素。