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一名老年鼻鳞状细胞癌患者的放疗相关口腔病变:病例报告

Radiotherapy-Associated Oral Lesions in a Geriatric Patient with Nasal Squamous Cell Carcinoma: A Case Report.

作者信息

Fetriani Ulfa, Hidayat Wahyu

机构信息

Oral Medicine Residency Program, Department of Oral Medicine, Faculty of Dentistry, Padjadjaran University, Bandung, West Java, Indonesia.

Department of Oral Medicine, Faculty of Dentistry, Padjadjaran University, Bandung, West Java, Indonesia.

出版信息

Int Med Case Rep J. 2025 Jun 2;18:663-669. doi: 10.2147/IMCRJ.S516633. eCollection 2025.

Abstract

BACKGROUND

Patients who receive chemotherapy or radiotherapy may experience oral complications such as oral mucositis, xerostomia, dental caries, periodontal disease, tissue fibrosis, opportunistic infections of the mucous membranes, neurosensory disorders, loss of taste, osteoradionecrosis, and trismus. This complication often causes high morbidity, oral frailty, and decreased quality of life. Oral mucositis is a common side effect of radiotherapy and often causes nutritional disorders and interruption in treatment.

PURPOSE

This case report shows topical management in radiotherapy-treated geriatric patients with multiple oral lesions. It also shows the effectiveness of topical therapy for oral lesions in this case.

CASE PRESENTATION

A 76-year-old male patient underwent radiotherapy for stage 4 nasal squamous cell carcinoma. After 22 radiotherapy sessions, the patient developed oral mucositis Grade 3 based on WHO criteria, characterized by painful ulcers, trismus, and dysphagia.

CASE MANAGEMENT

The patient was given topical drug therapy with a combination of 0.9% NaCl compress, 0.025% hyaluronic acid mouthwash, and petroleum jelly. Significant improvement was observed within five days, and resolution of oral mucositis occurred at the third visit.

CONCLUSION

Management of oral lesions in geriatric patients receiving radiotherapy or chemotherapy is useful to prevent disruption of treatment and reduce the risk of oral frailty.

摘要

背景

接受化疗或放疗的患者可能会出现口腔并发症,如口腔黏膜炎、口干症、龋齿、牙周疾病、组织纤维化、黏膜机会性感染、神经感觉障碍、味觉丧失、放射性骨坏死和牙关紧闭。这种并发症常导致高发病率、口腔功能衰退和生活质量下降。口腔黏膜炎是放疗的常见副作用,常导致营养紊乱和治疗中断。

目的

本病例报告展示了对接受放疗的老年多口腔病变患者的局部治疗。它还展示了本病例中局部治疗对口腔病变的有效性。

病例介绍

一名76岁男性患者因4期鼻鳞状细胞癌接受放疗。22次放疗后,根据世界卫生组织标准,患者出现3级口腔黏膜炎,表现为疼痛性溃疡、牙关紧闭和吞咽困难。

病例管理

给予患者局部药物治疗,联合使用0.9%氯化钠湿敷、0.025%透明质酸漱口水和凡士林。五天内观察到显著改善,第三次就诊时口腔黏膜炎消退。

结论

对接受放疗或化疗的老年患者进行口腔病变管理,有助于防止治疗中断并降低口腔功能衰退风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b55f/12143291/98fc2b0b190a/IMCRJ-18-663-g0001.jpg

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