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口腔内支架在减少上颌或鼻腔恶性肿瘤放疗中口腔不良反应的有效性。

Effectiveness of intraoral stents in reducing oral adverse events during radiotherapy for maxillary or nasal cavity malignant tumors.

机构信息

Department of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara, 634-8522, Japan.

Department of Radiation Oncology, Nara Medical University, Kashihara, 634-8522, Japan.

出版信息

Support Care Cancer. 2024 Feb 8;32(3):150. doi: 10.1007/s00520-024-08340-6.

Abstract

PURPOSE

Many patients experience oral adverse events during head and neck cancer radiotherapy (RT). The methods of management of such events are under debate. One such technique is the intraoral stent (IOS) technique, which removes normal tissue from the irradiation field. This retrospective study examined the factors associated with the occurrence of oral mucositis (OM) and dysgeusia and the efficacy of IOSs in preventing them.

METHODS

Twenty-nine patients who underwent RT in the maxilla or nasal cavity between 2016 and 2022 were included. They were investigated for background characteristics, treatment factors (IOS and dose-volume histogram), and oral adverse events (OM and dysgeusia).

RESULTS

Significant risk factors for the incidence of grade ≥ 2 (Common Terminology Criteria for Adverse Events v5.0) OM were the non-use of IOSs (p = 0.004) and diabetes (p = 0.025). A significant risk factor for the incidence of grade ≥ 1 dysgeusia was concomitant chemotherapy (p = 0.019). The radiation dose to the tongue was significantly lower in the IOS group than in the non-IOS group.

CONCLUSION

Our findings suggest that the use of an IOS during RT reduces the severity of OM by reducing irradiation to the tongue. Therefore, the use of an IOS is recommended during RT performed in the maxilla or nasal cavity.

摘要

目的

许多头颈部癌症放疗(RT)患者会出现口腔不良反应。这些事件的处理方法仍存在争议。其中一种技术是口腔内支架(IOS)技术,它可以将正常组织从照射野中移除。本回顾性研究旨在探讨与口腔黏膜炎(OM)和味觉障碍发生相关的因素,以及 IOS 预防这些不良反应的效果。

方法

本研究纳入了 2016 年至 2022 年间接受上颌或鼻腔 RT 的 29 例患者。对他们的背景特征、治疗因素(IOS 和剂量体积直方图)以及口腔不良反应(OM 和味觉障碍)进行了调查。

结果

发生≥2 级(不良事件通用术语标准 5.0)OM 的显著危险因素是非使用 IOS(p=0.004)和糖尿病(p=0.025)。同时接受化疗是发生≥1 级味觉障碍的显著危险因素(p=0.019)。IOS 组的舌照射剂量明显低于非 IOS 组。

结论

我们的研究结果表明,在 RT 期间使用 IOS 可减少舌照射量,从而降低 OM 的严重程度。因此,在进行上颌或鼻腔 RT 时,建议使用 IOS。

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