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颌骨放射性骨坏死患者预后的相关危险因素:一项15年的单机构经验。

Risk factors associated with prognosis in patients with osteoradionecrosis of the jaws: A single institutional experience over 15 years.

作者信息

Li C, Gong Z, Jumatai S, Fang C, Pataer P, Zhao H

机构信息

Department of Oral and Maxillofacial Oncology and Surgery School / Hospital of Stomatology the First Affiliated Hospital of Xinjiang Medical University Stomatological Research Institute of Xinjiang Uygur Autonomous Region National Clinical Medical Research Institute No. 137 Liyushan South Road, 830054 Urumqi, China

出版信息

Med Oral Patol Oral Cir Bucal. 2025 Jul 1;30(4):e597-e604. doi: 10.4317/medoral.27164.

Abstract

BACKGROUND

Osteoradionecrosis of the jaws (ORNJ) is a pernicious complication of radiation therapy that significantly affects the quality of life of patients with head and neck cancer. The present study aimed to investigate the risk factors for the clinical prognosis of ORNJ in the same scenario.

MATERIAL AND METHODS

A cross-sectional study was designed and implemented in a tertiary teaching hospital from January 2005 to December 2020. A total of 106 patients were divided into normal wound healing group (n = 79) and delayed wound healing group (n = 27) according to two different prognosis. The risk factors associated with the prognosis in patients with ORNJ were comparatively analyzed via performing one-way and multifactorial logistic analyses.

RESULTS

The majority of the study cohort (n = 59, 55.7%) was found to be characterized with Glanzmann and Gratz grade 2 and followed up for a median of 38.6 months. Diabetes mellitus (P = .045), Charlson comorbidity index (P = .042), American Society of Anesthesiologists score (P < .001), primary tumour site (P = .012), T stage (P = .008), ORNJ grade at initial diagnosis (P < .001), pan-immune-inflammatory value and systemic immune-inflammatory index at initial radiotherapy (P = .01 and P < .001 respectively) were detected as risk factors associated with poor prognosis in patients with ORNJ.

CONCLUSIONS

We conclude that there are abundant risk factors for poor prognosis in these patients, and it is important to be evaluated before irradiation so that suitable post-radiated treatments can be given.

摘要

背景

颌骨放射性骨坏死(ORNJ)是放射治疗的一种严重并发症,显著影响头颈癌患者的生活质量。本研究旨在调查在相同情况下ORNJ临床预后的危险因素。

材料与方法

2005年1月至2020年12月在一家三级教学医院开展并实施了一项横断面研究。根据两种不同的预后情况,将106例患者分为伤口愈合正常组(n = 79)和伤口愈合延迟组(n = 27)。通过进行单因素和多因素逻辑分析,对ORNJ患者预后相关的危险因素进行比较分析。

结果

研究队列中的大多数患者(n = 59,55.7%)为格兰茨曼和格拉茨2级,中位随访时间为38.6个月。发现糖尿病(P = 0.045)、查尔森合并症指数(P = 0.042)、美国麻醉医师协会评分(P < 0.001)、原发肿瘤部位(P = 0.012)、T分期(P = 0.008)、初始诊断时的ORNJ分级(P < 0.001)、初始放疗时的全免疫炎症值和全身免疫炎症指数(分别为P = 0.01和P < 0.001)是与ORNJ患者预后不良相关的危险因素。

结论

我们得出结论,这些患者预后不良存在多种危险因素,放疗前进行评估很重要,以便给予合适的放疗后治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f37/12221146/1b45d8f873d0/medoral-30-04-e597-g001.jpg

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