https://scholars.lib.ntu.edu.tw/handle/123456789/569721
標題: | A clinical staging system and treatment guidelines for maxillary osteoradionecrosis in irradiated nasopharyngeal carcinoma patients | 作者: | SHIH-JUNG CHENG JANG-JAER LEE Ting L.-L. Tseng I.-Y. HAO-HUENG CHANG HSIN-MING CHEN Kuo Y.-S. Hahn L.-J. SANG-HENG KOK |
公開日期: | 2006 | 卷: | 64 | 期: | 1 | 起(迄)頁: | 90-97 | 來源出版物: | International Journal of Radiation Oncology Biology Physics | 摘要: | Purpose: To develop a clinical staging system for maxillary osteoradionecrosis (ORN) in irradiated nasopharyngeal carcinoma (NPC) patients. Methods and Materials: The data of maxillary ORN cases among 1,758 irradiated NPC patients were analyzed. A staging system based on the degrees of bone exposure (E), infection (I), and bleeding (B) was developed. Correlations between various clinical parameters and stages of maxillary ORN and relationships between treatment modalities and outcomes at each stage were evaluated. Cumulative success of treatment and risk factors that affect treatment outcomes were analyzed. Results: The incidence of maxillary ORN was 2.7% (48/1,758). TNM stage of NPC (p < 0.001), radiation dose (p = 0.029), and tooth extraction (p < 0.001) appeared to have significant influences on disease severity. Success rates between conservative therapy and surgical treatment were not significantly different for Stage I ORN but differed significantly for Stage II (p = 0.013) and Stage III (p = 0.008) lesions. Grade 3 infection and bleeding significantly jeopardized treatment success (p = 0.043 and 0.015, respectively). The risk ratios of treatment failure for Grade 3 infection and bleeding were 2.523 (p = 0.034) and 3.141 (p = 0.027), respectively. Conclusions: More serious maxillary ORN tended to occur in cases with more advanced NPC, higher radiation dose, and history of tooth extraction. Surgical treatment was usually required in Stage II and III ORN. The grades of infection and bleeding are important factors in guidance of treatment and prediction of outcomes. ? 2006 Elsevier Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-29244483698&doi=10.1016%2fj.ijrobp.2005.06.021&partnerID=40&md5=8ac8fd5c8201ebd497c08a71972de14e https://scholars.lib.ntu.edu.tw/handle/123456789/569721 |
ISSN: | 0360-3016 | DOI: | 10.1016/j.ijrobp.2005.06.021 | SDG/關鍵字: | Carcinogens; Dentistry; Disease control; Dosimetry; Patient treatment; Radiation effects; Bleedings; Infections; Maxilla; Nasopharyngeal carcinoma; Osteoradionecrosis; Oncology; adult; bleeding; bone necrosis; cancer staging; cancer surgery; conference paper; conservative treatment; controlled study; correlation analysis; disease severity; exposure; female; human; incidence; infection; major clinical study; male; maxilla; nasopharynx carcinoma; outcome assessment; practice guideline; prediction; priority journal; radiation dose; risk assessment; risk factor; tooth extraction; Female; Guidelines; Humans; Male; Maxillary Diseases; Middle Aged; Nasopharyngeal Neoplasms; Osteoradionecrosis; Radiotherapy Dosage; Retrospective Studies; Severity of Illness Index; Statistics |
顯示於: | 臨床牙醫學研究所 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。