Effectiveness of a protocol with antimicrobial photodynamic therapy for treating osteoradionecrosis: a retrospective study.

IF 2.8 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Supportive Care in Cancer Pub Date : 2025-01-04 DOI:10.1007/s00520-024-09114-w
Júlia Lopes Ferigatto, Fábio Luiz Coracin, Hélio Massaiochi Tanimoto, Vivian Palata Viola, Victor Tieghi-Neto, Diogo Dias Prado, Wellinton Yoshio Hirai, Valiana Alves Teodoro, Fabiana Lima Vazquez, Simone Hassan Khatib Rios
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Abstract

Objective: To compare the treatment of osteoradionecrosis (ORN) using a protocol that incorporates antimicrobial photodynamic therapy with a conventional treatment protocol.

Methodology: This retrospective study analyzed 55 patients diagnosed with ORN at a reference hospital between 2002 and 2021. Patients were treated using two different clinical protocols. Clinical treatment success was defined as the epithelialization of the ORN lesion, along with the absence of pain and local infection.

Results: A total of 53 ORN lesions were included, with a median development time of 30 months. The patient cohort was predominantly male (83.02%), with a median age of 58 years. The main causes of ORN were prosthetic trauma (28.30%) and dental extractions due to infection (32.07%). Good oral hygiene and hygiene of the lesion were identified as protective factors for achieving clinical success, with a significant correlation to lesion epithelialization (p ≤ 0.0001). ORN developed more rapidly in tumors of the oral cavity, with a median time of 8 months, compared to oropharyngeal tumors, which had a median time of 39 months (p = 0.01).

Conclusion: The proposed treatment protocol, which includes antimicrobial photodynamic therapy, demonstrated greater effectiveness compared to the conventional protocol, achieving clinical success in 75% of the lesions analyzed in a shorter timeframe (p ≤ 0.0001). Additionally, maintaining proper oral and lesion hygiene is crucial for successful outcomes, and ORN develops more rapidly in patients with oral cavity tumors.

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抗菌光动力治疗骨放射性坏死的有效性:一项回顾性研究。
目的:比较抗菌光动力治疗与常规治疗方案对放射性骨坏死(ORN)的治疗效果。方法:本回顾性研究分析了2002年至2021年间在参考医院诊断为ORN的55例患者。患者采用两种不同的临床方案进行治疗。临床治疗成功的定义是ORN病变上皮化,同时没有疼痛和局部感染。结果:共纳入53例ORN病变,中位发展时间为30个月。患者队列以男性为主(83.02%),中位年龄58岁。造成ORN的主要原因是假体外伤(28.30%)和感染拔牙(32.07%)。良好的口腔卫生和病变卫生被认为是获得临床成功的保护因素,与病变上皮化有显著相关性(p≤0.0001)。口腔肿瘤的ORN发展更快,中位时间为8个月,口咽肿瘤的中位时间为39个月(p = 0.01)。结论:拟议的治疗方案,包括抗菌光动力治疗,与传统方案相比,显示出更大的有效性,在更短的时间内,75%的病变获得了临床成功(p≤0.0001)。此外,保持适当的口腔和病变卫生对于成功治疗至关重要,口腔肿瘤患者发生ORN的速度更快。
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来源期刊
Supportive Care in Cancer
Supportive Care in Cancer 医学-康复医学
CiteScore
5.70
自引率
9.70%
发文量
751
审稿时长
3 months
期刊介绍: Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease. Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.
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