鼻咽癌放射性龋齿发病规律及相关因素分析

发布时间：2018-04-03 11:30

  本文选题：鼻咽癌　切入点：调强放疗　出处：《中华肿瘤防治杂志》2017年06期

【摘要】：目的放射性牙损伤是常见的放疗不良反应,严重影响患者的咀嚼和营养摄取。通过分析放射性龋齿的发病情况及相关因素,探讨如何减少和预防放射性牙损伤的发生。方法 2007-06-25-2013-04-31在广州医科大学附属肿瘤医院放疗五区行放疗的初治鼻咽癌患者中,选取有放疗结束2年后口腔随诊资料的254例患者为研究对象。口腔检查时间距离放疗2~8年,中位时间3.5年。记录龋失补牙数,分析比较不同性别、年龄、放疗技术、放疗后不同时间段的患龋率和龋均,以及不同放疗技术的常见患龋牙位。结果调强放疗组(intensity-modulated radiation therapy,IMRT)牙齿剂量为(33.31±6.77)Gy,三维适形组(3-dimentional conformal radiation therapy,3D-CRT)为(41.05±1.58)Gy,差异有统计学意义,P=0.039;IMRT组,3D-CRT组,二维放疗组(2-dimentional radiation therapy,2DRT)的龋均分别为6.51±7.18、9.03±8.12和13.79±9.96,差异有统计学意义,P=0.001;254例患者龋均为8.16±8.20,失牙率为33.43%,补牙率为17.27%;上下牙列的龋均为4.24±4.22和3.92±4.47,差异无统计学意义,P=0.944;后组磨牙与其他牙齿的龋均为4.98±4.12和3.18±4.68,年龄≥50岁与50岁患者的龋均为11.63±9.09和5.41±6.48,放疗3年后与3年内的龋均为10.87±9.56和5.88±5.10,差异均有统计学意义,P0.001;性别不是龋齿发生的影响因素(男7.88±7.97,女8.86±8.77),P=0.541。结论增强鼻咽癌患者的护齿意识和龋病治疗意识,放疗尽量采用调强放疗技术,降低牙齿受照剂量,重点关注中老年患者的牙齿健康,有可能减少放射性龋齿的发生。
[Abstract]:Objective Radiation-induced tooth injury is a common adverse reaction of radiotherapy, which seriously affects the mastication and nutritional uptake of patients.By analyzing the incidence and related factors of radioactive dental caries, this paper discusses how to reduce and prevent the occurrence of radioactive tooth injury.Methods 254 patients with nasopharyngeal carcinoma who were treated with radiotherapy in the fifth region of the affiliated Cancer Hospital of Guangzhou Medical University from June to June to March 31, 2013-04-31 were selected from 254 patients with oral follow-up data 2 years after the end of radiotherapy.The time of oral examination was 2 ~ 8 years after radiotherapy, and the median time was 3.5 years.The number of missing teeth was recorded, and the different sex, age, radiotherapy technique, the incidence and mean of caries in different time after radiotherapy, and the common dental caries of different radiotherapy techniques were analyzed and compared.Results the tooth dose of intensity-modulated radiation therapy in IMRT group was 33.31 卤6.77 Gy, while that in three-dimensional conformal group was 41.05 卤1.58 Gy. The difference was statistically significant in 3D-CRT group.浜岀淮鏀剧枟缁，

本文编号：1705023