Pediatric Oncology Division, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Rio de Janeiro, Brazil.
Radiation Oncology Division, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Rio de Janeiro, Brazil.
Support Care Cancer. 2024 Sep 7;32(10):642. doi: 10.1007/s00520-024-08843-2.
Orbital rhabdomyosarcoma is a rare soft tissue sarcoma in childhood but with a good prognosis. Treatment usually includes surgery, chemotherapy, and radiotherapy. This study aimed to evaluate long-term alterations in teeth and cranial bones in children, adolescents, and young adults after oncologic treatment for childhood orbital rhabdomyosarcoma.
This was a cross-sectional study that evaluated patients treated for orbital rhabdomyosarcoma between 1988 and 2011. Demographic, clinical, and treatment data were collected during the study period; also, panoramic radiographs, cephalometric study, and photographs of the face were taken.
Eight long-term survivors were studied. Of those, 50% were male, 75% had less than 5 years of treatment, and 88% had only one of the orbits affected by the tumor. Regarding treatment, 50% received 50.4 Gy of radiotherapy in the orbit; the chemotherapy included vincristine, actinomycin D, and cyclophosphamide in 75% of the cases and also ifosfamide and etoposide in 25%. The children presented craniofacial alterations, mainly when radiotherapy occurred between 0 and 5 years old (p = 0.01). The mandibles also showed dental alterations, probably due to chemotherapy.
In conclusion, orbital RMS patients treated with chemoradiotherapy, important dental, and facial bone alterations were found. The most significant were in the maxilla and close to the irradiation field. Dental and mandibular bone alterations were also found, indicating the probable chemotherapy action, as this region was not included in the irradiation field.
眼眶横纹肌肉瘤是儿童期罕见的软组织肉瘤，但预后良好。治疗通常包括手术、化疗和放疗。本研究旨在评估儿童、青少年和年轻成人接受儿童眼眶横纹肌肉瘤肿瘤治疗后牙齿和颅骨的长期变化。
这是一项回顾性研究，评估了 1988 年至 2011 年间接受眼眶横纹肌肉瘤治疗的患者。在研究期间收集了人口统计学、临床和治疗数据；还拍摄了全景片、头颅侧位片和面部照片。
研究了 8 名长期幸存者。其中，50%为男性，75%的治疗时间少于 5 年，88%的肿瘤仅累及一只眼眶。关于治疗，50%的患者在眼眶接受了 50.4Gy 的放射治疗；化疗方案包括长春新碱、放线菌素 D 和环磷酰胺，占 75%，异环磷酰胺和依托泊苷占 25%。患儿存在颅面改变，主要发生在放疗发生于 0 至 5 岁之间时（p=0.01）。下颌也出现了牙齿改变，可能是由于化疗所致。
总之，接受放化疗的眼眶 RMS 患者存在重要的牙齿和颌骨改变。最显著的改变位于上颌骨，且靠近照射野。还发现了牙齿和下颌骨的改变，表明可能是化疗作用，因为该区域不包括在照射野内。
