Department of Pediatric Dentistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
Dent Med Probl. 2022 Jan-Mar;59(1):45-58. doi: 10.17219/dmp/138914.
Given the susceptibility of developing tissues to drugs, even small doses of anticancer drugs may affect odontogenesis. Although any toxic effect is transient, the treatment regimens are based on repeated drug administration.
The study aimed to establish the impact of antineoplastic therapy on the occurrence of longterm adverse dental effects in a dose-dependent manner in young survivors treated for cancer before 10 years of age.
In total, 37 cancer survivors treated with antineoplastic therapy before 10 years of age underwent a dental examination with a thorough analysis of panoramic radiographs. A total of 236 teeth with 243 different developmental abnormalities were revealed in 28 survivors. Agenesis, tooth size reduction, taurodontia, and enamel and root abnormalities were diagnosed. All survivors received multi-agent chemotherapy, with the most frequently used drugs being vincristine (VCR), doxorubicin (DXR), cyclophosphamide (CP), ifosfamide (IF), etoposide (VP-16), carboplatin (CBDCA), cisplatin (CDDP), and actinomycin-D (ActD). A detailed analysis of medical records was also performed to assess the relationship between the treatment duration as well as the cumulative drug dose administered and the occurrence of particular disturbances.
When analyzing the treatment duration and the drug doses in the affected and non-affected participants, there were no statistically significant differences between the survivors with different disturbances within most of the specific drug groups. In some groups, the mean cumulative treatment dose was significantly higher in the non-affected patients. According to Spearman's rho, no significant relationships were observed.
In the present study, no significant differences in terms of treatment duration or drug doses were observed between the patients with particular abnormalities. The developmental stage of tooth formation during chemotherapy is likely the most important factor influencing dental changes. For future research with respect to different treatment protocols, an analysis of a more homogenous group of survivors is warranted.
由于发育中的组织对药物敏感，即使小剂量的抗癌药物也可能影响牙发生。虽然任何毒性作用都是暂时的，但治疗方案是基于重复给药。
本研究旨在确定在 10 岁前接受抗癌治疗的年轻幸存者中，以剂量依赖的方式进行抗肿瘤治疗对长期不良牙齿影响的发生的影响。
共有 37 名 10 岁前接受抗肿瘤治疗的癌症幸存者接受了牙科检查，并对全景片进行了详细分析。在 28 名幸存者中发现了 236 颗牙齿，共有 243 颗不同的发育异常。诊断为牙缺失、牙体缩小、尖牙畸形和釉质及牙根异常。所有幸存者均接受多药化疗，最常使用的药物有长春新碱（VCR）、多柔比星（DXR）、环磷酰胺（CP）、异环磷酰胺（IF）、依托泊苷（VP-16）、卡铂（CBDCA）、顺铂（CDDP）和放线菌素-D（ActD）。还对病历进行了详细分析，以评估治疗持续时间以及给予的累积药物剂量与特定异常发生之间的关系。
在分析受影响和未受影响参与者的治疗持续时间和药物剂量时，大多数特定药物组中，具有不同异常的幸存者之间没有统计学上的显著差异。在一些组中，未受影响患者的平均累积治疗剂量明显更高。根据 Spearman 的 rho，没有观察到显著的关系。
在本研究中，在特定异常患者中，治疗持续时间或药物剂量没有观察到显著差异。牙形成过程中的化疗发育阶段可能是影响牙齿变化的最重要因素。对于不同治疗方案的未来研究，有必要对更同质的幸存者组进行分析。
