發(fā)布時(shí)間：2018-04-03 11:30

  本文選題：鼻咽癌　切入點(diǎn)：調(diào)強(qiáng)放療　出處：《中華腫瘤防治雜志》2017年06期

【摘要】：目的放射性牙損傷是常見(jiàn)的放療不良反應(yīng),嚴(yán)重影響患者的咀嚼和營(yíng)養(yǎng)攝取。通過(guò)分析放射性齲齒的發(fā)病情況及相關(guān)因素,探討如何減少和預(yù)防放射性牙損傷的發(fā)生。方法 2007-06-25-2013-04-31在廣州醫(yī)科大學(xué)附屬腫瘤醫(yī)院放療五區(qū)行放療的初治鼻咽癌患者中,選取有放療結(jié)束2年后口腔隨診資料的254例患者為研究對(duì)象�？谇粰z查時(shí)間距離放療2~8年,中位時(shí)間3.5年。記錄齲失補(bǔ)牙數(shù),分析比較不同性別、年齡、放療技術(shù)、放療后不同時(shí)間段的患齲率和齲均,以及不同放療技術(shù)的常見(jiàn)患齲牙位。結(jié)果調(diào)強(qiáng)放療組(intensity-modulated radiation therapy,IMRT)牙齒劑量為(33.31±6.77)Gy,三維適形組(3-dimentional conformal radiation therapy,3D-CRT)為(41.05±1.58)Gy,差異有統(tǒng)計(jì)學(xué)意義,P=0.039;IMRT組,3D-CRT組,二維放療組(2-dimentional radiation therapy,2DRT)的齲均分別為6.51±7.18、9.03±8.12和13.79±9.96,差異有統(tǒng)計(jì)學(xué)意義,P=0.001;254例患者齲均為8.16±8.20,失牙率為33.43%,補(bǔ)牙率為17.27%;上下牙列的齲均為4.24±4.22和3.92±4.47,差異無(wú)統(tǒng)計(jì)學(xué)意義,P=0.944;后組磨牙與其他牙齒的齲均為4.98±4.12和3.18±4.68,年齡≥50歲與50歲患者的齲均為11.63±9.09和5.41±6.48,放療3年后與3年內(nèi)的齲均為10.87±9.56和5.88±5.10,差異均有統(tǒng)計(jì)學(xué)意義,P0.001;性別不是齲齒發(fā)生的影響因素(男7.88±7.97,女8.86±8.77),P=0.541。結(jié)論增強(qiáng)鼻咽癌患者的護(hù)齒意識(shí)和齲病治療意識(shí),放療盡量采用調(diào)強(qiáng)放療技術(shù),降低牙齒受照劑量,重點(diǎn)關(guān)注中老年患者的牙齒健康,有可能減少放射性齲齒的發(fā)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 鹵6.77 Gy, while that in three-dimensional conformal group was 41.05 鹵1.58 Gy. The difference was statistically significant in 3D-CRT group.浜岀淮鏀劇枟緇，

本文編號(hào)：1705023