Veld Matthijs In 't, Leusink Frank K J, Chhangur Chayenne N, Su Naichuan, Jansen Femke, Vergeer Marije R, Leeuw Irma M Verdonck-de, Schulten Engelbert A J M
Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Department of Oral Public Health, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
Support Care Cancer. 2025 Sep 11;33(10):846. doi: 10.1007/s00520-025-09879-8.
This retrospective observational study examined oral rehabilitation and the total oral rehabilitation time (TORT) in head and neck cancer patients (HNC) who underwent full dental clearance before intensity-modulated radiotherapy (IMRT). Additionally, it assessed changes in health-related quality of life (HRQoL) before and after IMRT and oral rehabilitation.
HNC patients with HRQol data who underwent full dental clearance before IMRT in Amsterdam UMC between 2008 and 2021 were included. The EORTC QLQ-C30 and QLQ-H&N35 were used to assess HRQoL before dental clearance at baseline (T), after dental clearance and IMRT (T), after oral rehabilitation with conventional dentures (T), and after oral rehabilitation with implant-retained overdentures (T).
HRQoL data were available for 28 patients at T, T, and T; all received conventional dentures (TORT 13.5 months; range 4.8-64.0). Five also received implant-retained overdentures (TORT 29.8 months; range 25.8-31.5). Role and cognitive functioning declined at T vs. T (p < 0.01, p = 0.01), while emotional functioning improved (p < 0.01). HRQoL symptoms increased significantly at T vs. T, including taste and smell, social contact troubles, and dry mouth. At T, oral pain, supplement use, and weight gain decreased significantly (p = 0.05, p = 0.02, p < 0.01), while teeth and financial problems (p = 0.01, p = 0.04) increased compared to T.
All HNC patients in this study underwent dental clearance before IMRT and received oral rehabilitation with conventional dentures, with a mean TORT of over a year. Patients after oral rehabilitation had less oral pain but more problems with teeth and finances. Large prospective cohort studies are needed to confirm these findings.
这项回顾性观察研究调查了在调强放射治疗(IMRT)前进行全牙清除的头颈癌患者(HNC)的口腔修复及总口腔修复时间(TORT)。此外,还评估了IMRT和口腔修复前后健康相关生活质量(HRQoL)的变化。
纳入2008年至2021年期间在阿姆斯特丹大学医学中心接受IMRT前进行全牙清除且有HRQoL数据的HNC患者。使用欧洲癌症研究与治疗组织(EORTC)QLQ-C30和QLQ-H&N35量表在基线(T0)全牙清除前、全牙清除及IMRT后(T1)、使用传统假牙进行口腔修复后(T2)以及使用种植体固位覆盖义齿进行口腔修复后(T3)评估HRQoL。
在T0、T1和T2时,28例患者有HRQoL数据;所有患者均接受了传统假牙修复(TORT为13.5个月;范围4.8 - 64.0个月)。5例患者还接受了种植体固位覆盖义齿修复(TORT为29.8个月;范围25.8 - 31.5个月)。与T0相比,T1时角色功能和认知功能下降(p < 0.01,p = 0.01),而情感功能改善(p < 0.01)。与T1相比,T2时HRQoL症状显著增加,包括味觉和嗅觉、社交接触问题以及口干。在T2时,口腔疼痛、补充剂使用和体重增加显著减少(p = 0.05,p = 0.02,p < 0.01),而与T1相比,牙齿问题和经济问题增加(p = 0.01,p = 0.04)。
本研究中的所有HNC患者在IMRT前均进行了全牙清除,并接受了传统假牙的口腔修复,平均TORT超过一年。口腔修复后的患者口腔疼痛减轻,但牙齿和经济问题增多。需要大型前瞻性队列研究来证实这些发现。