Association of Cyclophosphamide Use With Dental Developmental Defects and Salivary Gland Dysfunction in Recipients of Childhood Antineoplastic Therapy
Association of Cyclophosphamide Use With Dental Developmental Defects and Salivary Gland Dysfunction in Recipients of Childhood Antineoplastic Therapy
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DOI：
10.1002/cncr.25704
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发表时间：
2011-05-15
期刊：
影响因子：
6.2
通讯作者：
Arora, Manish
中科院分区：
文献类型：
--
作者：
Hsieh, Susan Gyea-Su;Hibbert, Sally;Arora, Manish
背景技术背景：本研究的目的是探讨儿童期正畸治疗对牙齿发育和唾液功能的影响。方法：参加澳大利亚新南威尔士州韦斯特米德儿童医院长期随访门诊的患者，如果他们在16岁之前接受过治疗并且缓解超过5年，则被纳入。对每位参与者进行牙科检查和唾液测试。Holtta缺损指数（HDI）用于评估牙齿发育不全、小牙和正断层摄影（OPG）上的牙冠比。多变量调整回归分析用于估计患者特征和治疗方式与牙科结果的相关性。结果：招募了106名参与者（61%为男性）（应答率= 88%）。平均HDI评分为24.7 +/- 17.8。环磷酰胺的累积剂量> 7500 mg/m2时，HDI评分增加13.06（P = .01）。接受环磷酰胺治疗的患者出现极低唾液流量（< 0.7 mL/min）的几率也显著增加（比值比= 12.43; 95%置信区间，2.08-74.35; P = 0.006）。结论：接受高剂量环磷酰胺的儿童和青少年发生牙齿紊乱的风险增加。环磷酰胺接受者也有更大的风险表现出非常低的唾液流量。本研究将HDI应用于接受所有形式的环磷酰胺治疗的患者，并强调了环磷酰胺累积剂量与牙齿障碍之间的剂量依赖关系。Cancer 2011; 117：2219-27. (C)2010美国癌症协会
BACKGROUND: The aim of this study was to examine the effect of antineoplastic therapy on dental development and saliva function in recipients of childhood antineoplastic therapy. METHODS: Patients attending the long-term follow-up clinic at Children's Hospital at Westmead, NSW, Australia, were included if they had received treatment prior to 16 years of age and were in remission for more than 5 years. A dental examination and saliva test were performed for each participant. Holtta's Defect Index (HDI) was used to assess tooth aplasia, microdontia, and root-crown ratio on an orthopantomogram (OPG). Multivariable-adjusted regression analyses were used to estimate the association of patient characteristics and treatment modalities with dental outcomes. RESULTS: One hundred six participants (61% male) were recruited (response rate = 88%). The mean HDI score was 24.7 +/- 17.8. A cumulative dose of cyclophosphamide > 7500 mg/m(2) increased the HDI score by 13.06 (P = .01). Recipients of cyclophosphamide also had significantly increased odds of exhibiting very low saliva flow (< 0.7 mL/min) (odds ratio = 12.43; 95% confidence interval, 2.08-74.35; P = .006). CONCLUSIONS: Children and adolescents who received high doses of cyclophosphamide were at increased risk of dental disturbances. Cyclophosphamide recipients were also at greater risk of exhibiting very low saliva flow. This study applied the HDI to patients receiving all forms of antineoplastic treatment and highlights the dose-dependent relation between cumulative dose of cyclophosphamide and dental disturbances. Cancer 2011; 117: 2219-27. (C) 2010 American Cancer Society.