Ferigatto Júlia Lopes, Coracin Fábio Luiz, Tanimoto Hélio Massaiochi, Viola Vivian Palata, Tieghi-Neto Victor, Prado Diogo Dias, Hirai Wellinton Yoshio, Teodoro Valiana Alves, Vazquez Fabiana Lima, Rios Simone Hassan Khatib
Researcher at the Molecular Oncology Research Center, Barretos Cancer Hospital, 1331 Antenor Duarte Vilela Street - Dr. Paulo Prata, Barretos, São Paulo, 14784-400, Brazil.
Dentistry Department, Barretos Cancer Hospital, Barretos, São Paulo, Brazil.
Support Care Cancer. 2025 Jan 4;33(1):69. doi: 10.1007/s00520-024-09114-w.
To compare the treatment of osteoradionecrosis (ORN) using a protocol that incorporates antimicrobial photodynamic therapy with a conventional treatment protocol.
This retrospective study analyzed 55 patients diagnosed with ORN at a reference hospital between 2002 and 2021. Patients were treated using two different clinical protocols. Clinical treatment success was defined as the epithelialization of the ORN lesion, along with the absence of pain and local infection.
A total of 53 ORN lesions were included, with a median development time of 30 months. The patient cohort was predominantly male (83.02%), with a median age of 58 years. The main causes of ORN were prosthetic trauma (28.30%) and dental extractions due to infection (32.07%). Good oral hygiene and hygiene of the lesion were identified as protective factors for achieving clinical success, with a significant correlation to lesion epithelialization (p ≤ 0.0001). ORN developed more rapidly in tumors of the oral cavity, with a median time of 8 months, compared to oropharyngeal tumors, which had a median time of 39 months (p = 0.01).
The proposed treatment protocol, which includes antimicrobial photodynamic therapy, demonstrated greater effectiveness compared to the conventional protocol, achieving clinical success in 75% of the lesions analyzed in a shorter timeframe (p ≤ 0.0001). Additionally, maintaining proper oral and lesion hygiene is crucial for successful outcomes, and ORN develops more rapidly in patients with oral cavity tumors.
比较采用包含抗菌光动力疗法的方案与传统治疗方案治疗放射性骨坏死（ORN）的效果。
这项回顾性研究分析了2002年至2021年期间在一家参考医院被诊断为ORN的55例患者。患者采用两种不同的临床方案进行治疗。临床治疗成功的定义为ORN病变上皮化，且无疼痛和局部感染。
共纳入53例ORN病变，中位发病时间为30个月。患者队列以男性为主（83.02%），中位年龄为58岁。ORN的主要病因是假体创伤（28.30%）和因感染导致的拔牙（32.07%）。良好的口腔卫生和病变部位卫生被确定为实现临床成功的保护因素，与病变上皮化显著相关（p≤0.0001）。与口咽肿瘤相比，口腔肿瘤中ORN发展更快，中位时间为8个月，而口咽肿瘤的中位时间为39个月（p=0.01）。
所提出的包括抗菌光动力疗法的治疗方案与传统方案相比显示出更高的有效性，在更短的时间内使75%的分析病变获得临床成功（p≤0.0001）。此外，保持适当的口腔和病变部位卫生对成功治疗至关重要，并且ORN在口腔肿瘤患者中发展更快。
