A multicenter retrospective investigation on the efficacy of perioperative oral management in cancer patients
A multicenter retrospective investigation on the efficacy of perioperative oral management in cancer patients
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DOI：
10.1097/md.0000000000019129
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发表时间：
2020-03-01
期刊：
影响因子：
1.6
通讯作者：
Kurita, Hiroshi
中科院分区：
文献类型：
--
作者：
Yamada, Shin-Ichi;Soutome, Sakiko;Kurita, Hiroshi
患者在癌症治疗期间会出现许多口腔并发症。口腔细菌与牙齿局灶性感染的发生和口腔粘膜炎的进展有关。牙齿局灶性感染经常与菌血症、败血症和肺炎的全身性发作相关。口腔功能的退化与这些并发症可能成为癌症治疗的障碍。尽管日本对癌症患者进行了全面的口腔管理，包括口腔护理、清除牙齿病灶感染和使用义齿改善口腔功能，但很少有研究评估其疗效。本研究的目的是通过多中心回顾性分析，基于大量病例系列，调查癌症患者围手术期口腔管理（POM）的牙科/口腔并发症的发生率。回顾性分析癌症患者的病历资料，并调查口腔并发症的发生率和口腔治疗的效果。本研究共纳入2744例POM癌症患者（1684例男性和1080例女性，平均年龄65.9 ± 13.0岁）并进行了调查。在这些患者中，2097例（76.4%）在开始癌症治疗前开始POM，2130例（77.6%）仅接受口腔护理，391例（14.2%）接受侵入性治疗，如拔牙。癌症治疗期间牙齿局灶性感染的发生率为8.2%。最常见的感染是急性牙周炎，包括牙槽突（112例，4.1%）。2、3级口腔黏膜炎发生率为2.8%。在113名患者（4.1%）中观察到持续发热，其中7名患者（6.2%）患有牙齿病灶感染。这些发病率低于以前报告的发病率。基于对大量患者的分析，目前的结果支持口服管理在癌症患者中的疗效。然而，还需要进一步的研究来建立适当的口腔管理指南，为癌症患者。
Patients develop a number of oral complications during cancer treatments. Oral bacteria are associated with the onset of dental focal infections and the progression of oral mucositis. Dental focal infections are frequently associated with the systemic onset of bacteremia, sepsis, and pneumonia. The degeneration of oral function with these complications may become an obstacle to cancer treatments. Although comprehensive oral management, including oral care, the removal of dental focal infections, and improvements in oral function with dentures, is conducted for cancer patients in Japan, few studies have assessed its efficacy. The aim of the present study was to investigate the incidence of dental/oral complications in cancer patients with perioperative oral managements (POMs) based on a large number of case series with a multicenter retrospective analysis. The medical records of cancer patients with POMs were retrospectively reviewed and the incidence of oral complications and efficacy of oral management were investigated. A total of 2744 cancer patients with POMs (1684 males and 1080 females, mean age 65.9 +/- 13.0 years) were included and investigated in the present study. Among these patients, 2097 (76.4%) started POM before the initiation of cancer treatments, with 2130 (77.6%) receiving oral care only and 391 (14.2%) being subjected to invasive treatments, such as tooth extraction. The incidence of dental focal infections during the period of cancer treatments was 8.2%. The most frequent infection was acute periodontitis, including alveolar abscesses (112 patients, 4.1%). The incidence of grade 2 and 3 oral mucositis was 2.8%. Prolonged fever was observed in 113 patients (4.1%), with 7 having dental focal infections (6.2%). These incidence rates were lower than those reported previously. Based on analyses of a large number of patients, the present results support the efficacy of oral management in cancer patients. However, further studies are needed to establish adequate oral management guidelines for cancer patients.