Wang Yutian, Huang Zhou, Xiao Shaowen, Zheng Baomin, Zhao Dan, Liu Weixin, Xu Xiaolong, Wang Nan, Yang Chao, Zhang Yanqun, Sun Yan, Liu Hongwei
Department of Oral Medicine, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing, China.
Department of Radiation Oncology, Beijing Cancer Hospital & Beijing Institute for Cancer Research, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing, China.
J Dent Sci. 2025 Jan;20(1):522-528. doi: 10.1016/j.jds.2024.04.030. Epub 2024 May 6.
BACKGROUND/PURPOSE: Dental management prior to radiotherapy is often time-critical, and there are no studies on whether manipulations such as tooth extraction influence the risk of severe radiation-induced oral mucositis (ROM) during radiotherapy. Therefore, the aim of this study was to describe the relationship between dental management and the incidence of severe ROM.
A retrospective analysis was conducted on 144 head and neck cancer (HNC) patients who received dental management before radiotherapy at Peking University Cancer Hospital, from January 2016 to December 2017. Demographic characteristics, primary tumor features, cancer treatment characteristics, and severity of oral mucositis during radiotherapy were recorded. Univariate analysis and logistic regression analysis were used to explore factors associated with severe radiation-induced oral mucositis.
The incidence of grade 3 mucositis was 14.5% (22/144); univariate analysis showed that the number of extracted teeth (OR = 1.313; 95%CI = 1.012-1.702; = 0.040) and patients with primary oral cancer had a higher risk of developing grade 3 mucositis (OR = 3.848; 95% CI = 1.508-9.822; = 0.005). No statistical correlation was found between pre-radiation therapy prophylaxis, dental restoration, endodontic treatment, and grade 3 mucositis ( > 0.05). Logistic regression analysis showed that the number of extracted teeth (OR = 1.421, 95%CI = 1.071-1.885, = 0.015) and primary tumor location in the oral cavity (compared with other head and neck cancers) (OR = 5.165, 95%CI = 1.636-16.311, = 0.005) were significantly associated with grade 3 mucositis.
In HNC patients undergoing radiotherapy, the primary site located in the oral cavity and a higher number of teeth extracted are independent risk factors for the development of severe mucositis.
背景/目的：放疗前的牙科处理通常时间紧迫，且尚无关于拔牙等操作是否会影响放疗期间严重放射性口腔黏膜炎（ROM）风险的研究。因此，本研究旨在描述牙科处理与严重ROM发生率之间的关系。
对2016年1月至2017年12月在北京大学肿瘤医院接受放疗前牙科处理的144例头颈部癌（HNC）患者进行回顾性分析。记录人口统计学特征、原发肿瘤特征、癌症治疗特征以及放疗期间口腔黏膜炎的严重程度。采用单因素分析和逻辑回归分析来探讨与严重放射性口腔黏膜炎相关的因素。
3级黏膜炎的发生率为14.5%（22/144）；单因素分析显示，拔牙数量（OR = 1.313；95%CI = 1.012 - 1.702；P = 0.040）以及原发性口腔癌患者发生3级黏膜炎的风险更高（OR = 3.848；95%CI = 1.508 - 9.822；P = 0.005）。放疗前预防、牙齿修复、牙髓治疗与3级黏膜炎之间未发现统计学相关性（P > 0.05）。逻辑回归分析显示，拔牙数量（OR = 1.421，95%CI = 1.071 - 1.885，P = 0.015）以及口腔内原发肿瘤位置（与其他头颈部癌相比）（OR = 5.165，95%CI = 1.636 - 16.311，P = 0.005）与3级黏膜炎显著相关。
在接受放疗的HNC患者中，位于口腔的原发部位和较多的拔牙数量是发生严重黏膜炎的独立危险因素。
