BAŞ-BOYUN KANSERLERİNDE TEDAVİ ÖNCESİ DENTAL GİRİŞİMLER

Year 2012, Volume: 46 Issue: 2, 1 - 12, 04.09.2012

Kıvanç Bektaş Kayhan Kıvanç Bektaş Kayhan Meltem Özdemir-karataş Meltem Özdemir Karataş Meral Ünür Yaren Keskin Yaren Keskin Musa Altun Musa Altun Özlem Bayrak Oktay Yazıcıoğlu Oktay Yazıcıoğlu

Abstract

Amaç: Baş-boyun kanserlerinin tedavisinde uygulanan cerrahi, radyoterapi ve kemoterapi
sonucunda tat almada bozukluk, mukozit, ağız kuruluğu, radyasyon çürükleri, trismus, yara iyileşmesinde
gecikme ve osteoradyonekroz gibi yan etkiler oluşabilmektedir. Çalışmamızın amacı,
bu yan etkilerin önlenmesi ve/veya en aza indirilmesi için hastaların, tedavi öncesi ve sonrası
durumlarını karşılaştırmak ve dental değerlendirmenin önemini vurgulamaktır.
Gereç ve Yöntem: Bu çalışmada Ekim 2006-Kasım 2007 tarihleri arasında kliniğimize ağız
diş sağlığı konsültasyonu için başvuran 35 primer baş-boyun kanseri hastasının değerlendirilmesi,
uygulanan tedaviler ve ortalama 16,9 aylık takiplerinin sonuçları bildirilmiştir.
Bulgular: Hastaların onkoloji tedavisine dental olarak hazırlanmaları için tüm hastalara
periodontal olarak başlangıç tedavisi yapılmıştır. Ayrıca 9 hastanın toplam 28 dişine konservatif
restorasyonlar yapılırken, 9 hastaya sabit protez, 13 hastaya da hareketli protez uygulamaları
yapılmıştır.
Sonuç: Onkoloji tedavisine başlamadan önce yapılacak dental hazırlıklar, tedavi esnasında
ve sonrasında devam edecek düzenli kontroller, hastaların tedavi sonrasındaki dönemde ağız ve
diş sağlığı yönünden yaşayacakları problemleri en aza indirecek ve hayat kalitelerini arttıracaktır.

Keywords

Baş-boyun kanserleri, kemo-radyoterapi, dental değerlendirme, oral komplikasyonlar

References

• Jemal A, Bray F, Center M M , Ferlay J, Ward E, Froman D. Global cancer statistics. CA Cancer J Clin, 2011; 61: 69-90.
• A snapshot of head and neck cancers cer.gov/aboutnci/servingpeople/snapshots/ head-neck.pdf Erişim tarihi: 12 Aralık 2011.
• Haydaroğlu A, Bölükbaşı Y, Özsaran Z. Ege Üniversitesinde kanser kayıt analiz­ leri: 34134 olgunun değerlendirilmesi. Türk Onko Derg, 2007; 22: 22-28.
• Danaei G, Hoorn SV, Lopez AD, Mur­ ray CJL, Ezzati M , and the Comparative Risk Assessment collaborating Group. Causes of cancer in the world: comparative risk assess­ ment of nine behavioural and environmental risk factors. Lancet, 2005; 366: 1784-93.
• Gondivkar SM, Parikh RV, Gadbail A R Solanke V, Chole R, Mankar M , Balsaraf S. Involvement of viral factors with head and neck cancers. Oral Oncol, 2011 (baskıda).
• Moore SR, Johnson NW, Pierce A M , Wilson DF. The epidemiology of mouth cancer: a review of global incidence. Oral Diseases, 2000; 6: 65-74.
• Hancock PJ, Epstein JB, Sadler GR. Oral and dental management related to raı diation therapy for head and neck cancer. J
• Fanucchi M , Khuri FR, Shin D, John­ Cancer Ther, 2006; 1: 211-19.
• Nabil S, Samman N . Incidence and review. Int J Oral Maxillofac Surg, 2011;
• Chrcanovic BR, Reher P, Sousa AA, Harris M . Osteoradionecrosis of the jaws--a current overview-Part 2: dental management 11 and therapeutic options for treatment. Oral Maxillofac Surg, 2010; 14(2): 81-95.
• Agbaje JO, Jacobs R, Michiels K, Abu-Ta'a M , van Steenberghe D. Bone he­ aling after dental extractions in irradiated patients: a pilot study on a novel technique for volume assessment of healing tooth soc­ kets. Clin Oral Investig, 2009; 13(3): 257-61. 77. Epub 2008 Nov 5.
• Lizi EC. A case for a dental surgeon pes RC, Carvalho AL, Scheper MA, Freire
• AR. Oral health status of 207 head and neck at regional radiotherapy centres. Br Dent J, 1992; 173(1): 24-26.
• Bonan PR, Lopes MA, Pires FR, A l ­ meida OP. Dental management of low socio­ economic level patients before radiotherapy of the head and neck with special emphasis on the prevention of osteoradionecrosis. Braz Dent J, 2006; 17(4): 336-42.
• Epstein JB, Parker IR, Epstein MS, Stevenson-Moore P. Cancer-related oral he­ alth care services and resources: a survey of oral and dental care in Canadian cancer cent­ res. J Can Dent Assoc, 2004; 70(5): 302-04.
• Marx RE, Johnson RP, Kline SN. Prevention of osteoradionecrosis: a randoı mized prospective clinical trial of hyperbaric oxygen versus penicillin. J Am Dent Assoc, 1985; 111(1): 49-54.
• Sulaiman F, Huryn JM, Zlotolow IM. Dental extractions in the irradiated head and neck patient: a retrospective analysis of Memorial Sloan-Kettering Cancer Center Filho V, Eluf-Neto J, Curado MP, Koifman protocols, criteria, and end results. J Oral Maxillofac Surg, 2003; 61(10): 1123-31.
• Marx RE, Johnson RP. Studies in the radiobiology of osteoradionecrosis and their clinical significance. Oral Surg Oral Med Oral Pathol, 1987; 64(4): 379-90.
• Thorn JJ, Hansen HS, Specht L, Bast- holt L. Osteoradionecrosis of the jaws: cli­ nical characteristics and relation to the field of irradiation. J Oral Maxillofac Surg, 2000; 58(10): 1088-93.
• Porter SR, Fedele S, Habbab K M . Xerostomia in head and neck malignancy. Oral Oncol, 2010 ; 46(6): 460-63.
• Rosales AC, Esteves SC, Jorge J, Almeida OP, Lopes M A . Dental needs in Brazilian patients subjected to head and neck radiotherapy. Braz Dent J, 2009; 20(1): 74ı
• Jham BC, Reis PM, Miranda EL, Loı cancer patients before, during and after raı diotherapy. Clin Oral Investig, 2008; 12(1): 19-24.
• Epstein JB, Emerton S, Lunn R, Le N , Wong FL. Pretreatment assessment and dental management of patients with nasop- haryngeal carcinoma. Oral Oncol, 1999; 35(1): 33-39.
• Muwonge R, Ramadas K , Sankila R, Thara S, Thomas G, Vinoda J, Sanka- ranarayanan R. Role of tobacco smoking, chewing and alcohol drinking in the risk of oral cancer in Trivandrum, India: a nested case-control design using incident cancer cases. Oral Oncol, 2008; 44(5): 446-54.
• Pelucchi C, Tramacere I , Boffetta P, Negri E, La Vecchia C. Alcohol consumption and cancer risk. Nutr Cancer, 2011; 63(7): 983-90.
• Szymahska K , Hung RJ, Wunsch- S, Matos E, Menezes A, Fernandez L, Daudt AW, Boffetta P, Brennan P. Alcohol and toı bacco, and the risk of cancers of the upper aerodigestive tract in Latin America: a case- control study. Cancer Causes Control, 2011; 22(7): 1037-46.
• Znaor A, Brennan P, Gajalakshmi V, Mathew A, Shanta V, Varghese C, Boffetta P. Independent and combined effects of tobacco smoking, chewing and alcohol drinking on the risk of oral, pharyngeal and esophageal ı2 cancers in Indian men. Int J Cancer, 2003; with cancer. Eur J Oncol Nurs, 2005; 9 Suppl 105(5): 681-86.
• Zygogianni A G , Kyrgias G, Kara- kitsos P, Psyrri A, Kouvaris J, Kelekis N , romandibular disorders and occlusion. St. Kouloulias V. Oral squamous cell cancer: Louis: Mosby; 1998. early detection and the role of alcohol and smoking. Head Neck Oncol, 2011; 3: 2.
• Ekramuddaula FM, Siddique BH, Is­ lam MR, Kabir MS, Alam MS. Evaluation reduces radiation-induced trismus in patients of risk factors of oral cancer. Mymensingh with nasopharyngeal carcinoma: a prospecti­ Med J, 2011; 20(3): 412-18.
• Caribe-Gomes F, Chimenos-Küstner E, Lopez-Lopez J, Finestres-Zubeldia F, Gu- ix-Melcior B. Dental management of the complications of radio and chemotherapy in oral cancer. Med Oral, 2003; 8(3): 178-87.
• Gökalp S, Güçiz Doğan B, Tekçiçek M , Berberoğlu A, Ünlüer Ş. Erişkin ve Yaşlı­ larda Ağız-Diş Sağlığı Profili Türkiye-2004. Hacettepe Dişhekimliği Fakültesi Dergisi, 2007; 31(4): 11-18.
• Tolentino Ede S, Centurion BS, Fer­ reira LH, Souza AP, Damante JH, Rubira- Bullen IR. Oral adverse effects of head and neck radiotherapy: literature review and suggestion of a clinical oral care guideline for irradiated patients. J Appl Oral Sci, 2011; 19(5): 448-54.
• Koga DH, Salvajoli JV, Kowalski LP, Nishimoto I N , Alves FA. Dental extractiı ons related to head and neck radiotherapy: ten-year experience of a single institution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2008; 105(5): e1-6.
• Koga D H , Salvajoli JV, Alves FA. Dental extractions and radiotherapy in head and neck oncology: review of the literature. Oral Dis, 2008; 14(1): 40-44.
• Feber T. Mouth care for patients reı ceiving oral irradiation. Prof Nurse, 1995; 10(10): 666-70.
• Stone R, Fliedner M C , Smiet AC. Management of oral mucositis in patients 1: S24-32.
• Okeson JP. Management of tempo­
• Chen YY, Zhao C, Wang J, Ma HL, Lai SZ, Liu Y, Han F, L u LX, Bao Y, Chen M . Intensity-modulated radiation therapy ve study with >5 years of follow-up. Cancer. 2011; 117(13): 2910-16.