个体口腔卫生质量对口咽区鳞状细胞癌放疗后黏膜炎严重程度的影响

A. Avanesov, E. Gvozdikova, T. Tarasova, D. Khaydar, A. Vinogradova, I. Zakharkin
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引用次数: 1

摘要

研究目的:放射治疗前后鳞状细胞口咽癌患者个体口腔卫生质量评价。材料和方法。对76例口咽区鳞状细胞癌进行了检查。对所有患者放疗前后的口腔卫生状况,采用以下指标进行评估:个人卫生指数(Green V.)、Silness - Loe指数(GI)、牙周病患病率指数(CPITN)。结果。男性多于女性:52例(68.4%)比24例(31.6%)。放疗前牙龈炎52例(68.4%),牙周炎66例(86.8%),金属冠43例(56.5%),破坏牙57例(76%)。放疗后所有患者(100%)均出现口腔黏膜炎。我们发现了显著的负趋势:Green v指数变化了29.2%,CPITN指标变化了38%,GI -变化了31.2% (p <0.05)。口腔黏膜炎的严重程度也与放射总剂量有直接关系。因此,口咽区鳞状细胞癌患者在总辐射剂量为30 Gy及以上时发生严重的口腔黏膜炎。总辐射剂量在40gy及以上的2/3病例可能发生4级口腔黏膜炎。结论。口腔黏膜炎的严重程度取决于总辐射剂量和患者最初的牙齿状况。因此,对口腔恶性肿瘤患者的个人口腔卫生和牙周支持的质量控制应贯穿于患者的整个治疗过程。
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INDIVIDUAL ORAL HYGIENE QUALITY INFLUENCE ON THE SEVERITY OF POST-RADIATION MUCOSITIS IN PATIENTS WITH SQUAMOUS CELL CARCINOMA OF THE OROPHARYNGEAL REGION
Purpose of the study . Assessment of the quality of individual oral hygiene in patients with squamous cell oropharyngeal cancer before and after radiation therapy. Materials and methods . Examined 76 patients with squamous cell carcinoma of the oropharyngeal region. For all patients, before and after radiation therapy, evaluated the hygienic state of the oral cavity using indices: index of individual hygiene (Green V.), Silness‑Loe index (GI), index of prevalence of periodontal diseases (CPITN). Results . The number of males was higher than that of females: 52 (68.4%) versus 24 (31.6%). Before radiotherapy, 52 (68.4%) patients had gingivitis, 66 (86.8%) had periodontitis, 43 (56.5%) had metal crowns, and 57 (76%) had destroyed teeth. All patients (100%) had oral mucositis after radiation therapy. We found a significant negative trend: the Green V. index changed by 29.2%, CPITN indicators‑by 38%, GI — by 31.2% ( p <0.05). There was also a direct dependence of the severity of oral mucositis on the total dose of radiation. Thus, patients with squamous cell carcinoma of the oropharyngeal region develop severe oral mucositis with a total radiation dose of 30 Gy and above. The probability of occurrence of oral mucositis of 4 severity is possible in 2/3 cases with a total radiation dose of 40 Gy or higher. Conclusion . The severity of oral mucositis depends on both the total radiation dose and the initial dental status of the patient. Therefore, quality control of individual oral hygiene and periodontal support for patients with oral malignancies should be carried out throughout the patient's treatment.
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