Kaste S C, Hopkins K P, Bowman L C
Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee 38101-0318, USA.
Med Pediatr Oncol. 1995 Aug;25(2):96-101. doi: 10.1002/mpo.2950250209.
To define the long-term dental sequelae of therapy for childhood rhabdomyosarcoma of the head and neck, and to identify factors in their development, we retrospectively reviewed the serial panoramic radiographs and clinical records of 22 survivors of head or neck rhabdomyosarcoma who had been followed for at least 5 years. Patients were divided into four groups based upon age at the time of therapy and three groups based upon radiation doses. All patients had received similar multiagent chemotherapy. Dental sequelae of oncotherapy occurred in over half of the long-term survivors of head and neck rhabdomyosarcoma. The abnormalities comprised root stunting in 54%, microdontia in 23%, and hypodontia in 50% of patients; 36% had multiple abnormalities. Microdontia and multiple abnormalities were more prevalent in patients treated at the earliest age, and abnormalities tended to be more prevalent with increasing doses of radiation. Five patients (23%) developed severe cosmetic and/or functional sequelae necessitating surgical and/or orthodontic intervention. The high frequency of dental sequelae we observed suggests that meticulous long-term dental and radiographic follow-up are needed. Early detection and treatment of the complications of therapy will expedite their correction and minimize morbidity.
为明确头颈部儿童横纹肌肉瘤治疗的长期牙齿后遗症，并确定其发生的相关因素，我们回顾性分析了22名头颈部横纹肌肉瘤幸存者的系列全景X线片和临床记录，这些患者均接受了至少5年的随访。根据治疗时的年龄将患者分为四组，根据放射剂量分为三组。所有患者均接受了类似的多药化疗。超过半数的头颈部横纹肌肉瘤长期幸存者出现了肿瘤治疗相关的牙齿后遗症。这些异常包括54%的患者牙根发育不全、23%的患者牙过小畸形和50%的患者牙缺失；36%的患者有多种异常。牙过小畸形和多种异常在最年幼时接受治疗的患者中更为普遍，且随着放射剂量增加，异常往往更普遍。5名患者（23%）出现了严重的美容和/或功能后遗症，需要进行手术和/或正畸干预。我们观察到的牙齿后遗症的高发生率表明，需要进行细致的长期牙齿和影像学随访。早期发现并治疗治疗并发症将加快纠正并减少发病率。
