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己酮可可碱、生育酚和螯合剂切除术治疗颌骨放射性骨坏死的疗效观察:一项病例系列研究。

Pentoxifylline, tocopherol, and sequestrectomy are effective for the management of advanced osteoradionecrosis of the jaws-a case series.

机构信息

Department of Oral Oncology, Hospital of Cancer of Pernambuco (HCP - PE), Recife, Pernambuco, Brazil.

Department of Clinical and Preventive Dentistry, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil.

出版信息

Support Care Cancer. 2021 Jun;29(6):3311-3317. doi: 10.1007/s00520-020-05847-6. Epub 2020 Oct 27.

Abstract

BACKGROUND

The aim of the present study was to evaluate the efficacy of pentoxifylline and tocopherol for the management of osteoradionecrosis of the jaws.

METHODS

Twenty-five patients diagnosed with osteoradionecrosis of the jaws treated with pentoxifylline 400 mg + tocopherol 400 mg three times daily (tid) were evaluated. Clinical records and image tests were reviewed. All patients were previously submitted to head and neck radiation therapy and presented with a clinical and radiographic diagnosis of osteoradionecrosis of the jaws.

RESULTS

Following therapy with pentoxifylline and tocopherol, 76% (19/25) of the patients showed complete mucosal healing, in which 47.3% (9/19) did not undergo sequestrectomy. From this particular group, 77.7% (7/9) were in stage I and 33.3% (3/9) used the protocol for up to 3 months. Among those who underwent to sequestrectomy, complete mucosal healing was observed in 52.7% (10/19). Among these, 60% (6/10) were in stage I and 100% of the patients were using the protocol for more than 3 months. In all other patients, partial healing of the mucosa was observed since they presented advanced disease. These represented 24% of the sample (6/25), 66.6% (4/6) were in stage III, and 60% (4/6) used the protocol for over 6 months.

CONCLUSION

Pentoxifylline and tocopherol may provide effective management of osteoradionecrosis of the jaws, and the association with sequestrectomy may avoid major surgical procedures.

摘要

背景

本研究旨在评估己酮可可碱和生育酚治疗颌骨放射性骨坏死的疗效。

方法

评估了 25 名接受己酮可可碱 400mg+生育酚 400mg 每日三次(tid)治疗的颌骨放射性骨坏死患者。回顾了临床记录和影像学检查。所有患者均曾接受头颈部放射治疗,并经临床和影像学诊断为颌骨放射性骨坏死。

结果

在接受己酮可可碱和生育酚治疗后,76%(19/25)的患者出现完全黏膜愈合,其中 47.3%(9/19)未行清创术。在这一组中,77.7%(7/9)处于 I 期,33.3%(3/9)使用该方案长达 3 个月。行清创术的患者中,有 52.7%(19/19)出现完全黏膜愈合。其中,60%(6/10)处于 I 期,100%的患者使用该方案超过 3 个月。在所有其他患者中,由于疾病处于晚期,仅观察到黏膜的部分愈合。这些患者占样本的 24%(6/25),66.6%(4/6)处于 III 期,60%(4/6)使用该方案超过 6 个月。

结论

己酮可可碱和生育酚可能为颌骨放射性骨坏死提供有效的治疗,与清创术联合应用可避免大手术。

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