Osteoradionecrosis in patients with salivary gland malignancies.
Osteoradionecrosis in patients with salivary gland malignancies.
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唾液腺恶性肿瘤患者的放射性骨坏死。
DOI：
10.1016/j.oraloncology.2016.03.006
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发表时间：
2016
期刊：
影响因子：
4.8
通讯作者：
Hutcheson,KatherineA
中科院分区：
文献类型：
--
作者：
Tucker,JRhet;Xu,Li;Sturgis,ErichM;Mohamed,AbdallahSR;Hofstede,TheresaM;Chambers,MarkS;Lai,StephenY;Fuller,CliftonDavid;Beadle,Beth;Gunn,GBrandon;Hutcheson,KatherineA
目的探讨涎腺恶性肿瘤(SGM)放射治疗后骨性放射性坏死(ORN)的发生情况。材料与方法回顾了12年来(2001年8月至2013年11月)172例涎腺恶性肿瘤放射治疗患者的临床资料。结果172例患者中，发生ORN 7例(4%)，中位潜伏期19个月，范围4~72个月。在这7名患者中，4名患者需要进行大手术，1名患者需要高压氧治疗，1名患者需要进行轻微清创，1名患者需要保守治疗。发生ORN的患者总剂量为50Gy1例~70Gy1例，其中4例在骨切除后给予放射治疗。7例ORN中有3例发生于骨外伤后。在发生ORN的7例患者中，3例发生在主腺上，3例发生在口腔其他部位，1例发生在鼻窦。结论虽然SGM放疗后ORN的发生率(4%)略低于先前报道的接受放射治疗的头颈部鳞状细胞癌患者(8-14%)，但需要进行大手术的ORN仍然是SGM幸存者放射治疗的一个具有临床意义的、可能的后遗症。SGM的位置非常重要，不成比例地发展为ORN的病例原发疾病发生在口腔。
PurposeThe present study was undertaken to evaluate osteoradionecrosis (ORN) in patients with salivary gland malignancies (SGM) after treatment with radiation therapy.Materials and methodsThe medical records of 172 patients treated with radiation therapy for SGM during a 12-year period (August 2001 to November 2013) were reviewed. Incidence, time to event, staging and management of ORN were analyzed.ResultsOf the 172 patients, 7 patients (4%) developed ORN (median latency: 19 months, range: 4–72 months). Of those 7 patients, 4 required major surgery, 1 required hyperbaric oxygen therapy (HBO), one required minor debridement, and one required conservative management. Total prescribed radiation dose varied from 50 Gy (1 case) to 70 Gy (1 case) among those patients who developed ORN, and radiotherapy was delivered postoperatively after osseous resection in 4 of 7 cases. Three of the 7 cases of ORN occurred after traumatic injury to the bone. Of the 7 patients who developed ORN, 3 had SGM of the major glands, 3 had other sites of the oral cavity, and 1 had a sinonasal location.ConclusionWhile the rate of ORN after radiotherapy for SGM was somewhat lower (4%) than previously published data on patients with squamous cell carcinomas of the head and neck treated with radiation therapy (8–14%), ORN necessitating major surgery remains a clinically significant, possible late effect of radiotherapy in SGM survivors. Location of SGM is very important, with cases that developed ORN disproportionally having primary disease arising in the oral cavity.