Roos D E, Dische S, Saunders M I
Department of Radiation Oncology, Royal Adelaide Hospital, South Australia.
Eur J Cancer B Oral Oncol. 1996 May;32B(3):176-81. doi: 10.1016/0964-1955(95)00083-6.
Between 1985 and 1990, 99 head and neck cancer patients were treated at Mount Vernon Centre for Cancer Treatment in a CHART pilot study. The aims of this retrospective review were to obtain baseline data for this population on their pretreatment dental status and to determine the extent to which our conservative policy of teeth preservation is being realised. This is of particular interest because of the believed sparing of late normal tissue effects by CHART compared with conventional fractionation. Prior to treatment, 40% of patients were edentulous, and prophylactic dental clearance was avoided in 59% of the remaining (dentate) patients. Following radiotherapy, only 21% of dentate patients subsequently lost all their remaining teeth. The proportion of patients with full or partial upper dentures increased from 61% pretreatment to 76% post-treatment; the corresponding increase in lower dentures was 46% to 66%. However, actual usage of dentures decreased somewhat. There was only one documented case of (minor) osteo-radionecrosis of the mandible which resolved with conservative care. The greater use in our patients of prophylactic measures, in particular, chlorhexidine and fluoride mouthwashes seemed indicated.
1985年至1990年间，在一项CHART试点研究中，99名头颈部癌症患者在弗农山癌症治疗中心接受了治疗。这项回顾性研究的目的是获取该人群治疗前牙齿状况的基线数据，并确定我们保守的牙齿保留政策的实现程度。这一点特别值得关注，因为与传统分割放疗相比，CHART被认为能减少晚期正常组织的损伤。治疗前，40%的患者无牙，在其余（有牙）患者中，59%的患者避免了预防性牙齿清除。放疗后，只有21%的有牙患者随后失去了所有剩余牙齿。全口或部分上颌假牙患者的比例从治疗前的61%增加到治疗后的76%；下颌假牙的相应比例从46%增加到66%。然而，假牙的实际使用率有所下降。记录在案的下颌（轻度）放射性骨坏死病例只有1例，经保守治疗后痊愈。似乎表明我们的患者更多地使用了预防措施，特别是洗必泰和含氟漱口水。
