Department of Dental and Prosthetic Services, Tata Memorial Hospital, TMC; Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India.
Department of Dental and Prosthetic Services, Tata Memorial Hospital, TMC; Homi Bhabha National Institute (HBNI); Fellowship in Dental and Prosthetic Oncology, Homi Bhabha National Institute, Mumbai, Maharashtra, India.
J Cancer Res Ther. 2022 Jul-Sep;18(4):1016-1022. doi: 10.4103/jcrt.JCRT_248_20.
Radiotherapy (RT) combined with chemotherapy and surgery is the indicated treatment for head and neck cancers. Even with the advent of modern technological advances in RT and improved oral hygiene awareness, osteoradionecrosis (ORN) still remains as one of the most debilitating side effects of RT.
This is a retrospective review assessing 72 patients aged over 18 years of age reporting in the Dental Department, for treatment of ORN from April 2010 to July 2019. Each patient was clinically examined and treated according to standard protocol. The stage of ORN was noted at the diagnosis and at follow-up. The demographic data, the tumor characteristics, and the treatment of patients were evaluated using descriptive statistics.
At the time of diagnosis, 84.7% of the study population was found to have Epstein Type II chronic persistent nonprogressive lesions and 11.1% of the cohort had Type III active progressive lesions. Statistically significant correlation (P = 0.00) was found for ORN grade at diagnosis and at follow-up. ORN being a chronic pathology, stabilization of the disease was observed in 72.3% of cases. The resolution of the necrotic lesion and down staging of the disease was seen only in 2.8% of patients.
ORN is mainly a chronic long standing pathology which is difficult to treat completely. Stabilization of symptoms and preventing further spread of the necrotic lesion should be the ultimate aim of the treatment to improve the quality of life of the patients.
放射治疗(RT)联合化疗和手术是头颈部癌症的标准治疗方法。即使现代 RT 技术进步和口腔卫生意识提高,放射性骨坏死(ORN)仍然是 RT 最具致残性的副作用之一。
这是一项回顾性研究,评估了 2010 年 4 月至 2019 年 7 月在牙科部门因 ORN 接受治疗的 72 名年龄在 18 岁以上的患者。每位患者均根据标准方案进行临床检查和治疗。在诊断和随访时记录 ORN 的分期。使用描述性统计数据评估患者的人口统计学数据、肿瘤特征和治疗情况。
在诊断时,研究人群中有 84.7%的患者被发现患有 Epstein Ⅱ型慢性持续性非进行性病变,11.1%的患者患有Ⅲ型活动性进行性病变。诊断时和随访时 ORN 分级存在统计学显著相关性(P=0.00)。ORN 是一种慢性病理,72.3%的病例观察到疾病稳定。只有 2.8%的患者观察到坏死病变的消退和疾病分期下降。
ORN 主要是一种慢性长期存在的病理,很难完全治愈。稳定症状和防止坏死病变进一步扩散应该是治疗的最终目标,以提高患者的生活质量。