口腔颌面部肿瘤放射性治疗后下颌骨发生放射性骨坏死的危险因素研究  

Risk factors of mandibular osteoradionecrosis after radiotherapy for oral and maxillofacial malignant tumors

作　　者：王恪钢[1] WANG Kegang(Department of Stomatology,Xinxiang Central Hospital,Xinxiang 453000,China)

机构地区：[1]新乡市中心医院口腔科,河南新乡453000

出　　处：《上海医药》2023年第17期37-41,共5页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的:明确下颌骨放射性骨坏死(ORN)发病的危险因素,为预防及临床治疗该病提供参考依据。方法:选取已完成放射治疗的口腔颌面头颈肿瘤患者353例,记录患者的基本信息、放疗情况、ORN发病时间等信息,分析ORN发病与可能的影响因素之间的关系。结果:共67例(19.0%)患者出现下颌骨ORN,平均发病时间为放疗结束后的(33.3±25.2)月;未出现下颌骨ORN的患者有286例(81.0%),放疗后平均随访时间为(43.3±26.8)月。共有9项变量(累计吸烟时长、放疗方式、放射剂量、放疗前下颌骨手术术式、放疗次数、肿瘤累及下颌骨、吸烟史、放疗前下颌骨手术史、2型糖尿病)与下颌骨ORN的发病具相关性(P<0.05)。结论:上述9项因素与下颌骨ORN发病相关,可作为ORN疾病预防与病因学研究的参考依据。Objective:To identify the risk factors of mandibular osteoradionecrosis(ORN),and to provide reference for the prevention and clinical treatment of this disease.Methods:Three hundred and fifty-three patients with oral and maxillofacial malignant tumors who had completed radiation therapy were selected,and the basic information of the patients,radiation therapy,and the time of onset of ORN were recorded to analyze the relationship between the onset of ORN and the possible influencing factors.Results:A total of 67(19.0%)patients developed mandibular ORN,with a mean onset time of(33.3±25.2)months after completion of radiotherapy;286(81.0%)patients did not develop mandibular ORN,with a mean follow-up time of(43.3±26.8)months after radiotherapy.A total of 9 variables(cumulative smoking duration,radiotherapy modality,radiation dose,preradiotherapy mandibular surgery procedure,number of radiotherapy sessions,tumor involvement of the mandible,smoking history,history of pre-radiotherapy mandibular surgery,and type 2 diabetes mellitus)were correlated with the development of mandibular ORN(P<0.05).Conclusion:The nine factors above mentioned were correlated with the development of mandibular ORN,which can be used as reference for the study of prevention and etiology of ORN disease.

关 键 词：放射性骨坏死 放射治疗 口腔颌面部肿瘤 下颌骨 危险因素 

分 类 号：R739.8[医药卫生—肿瘤] R730.55[医药卫生—临床医学]