放射線治療後の頭頸部がん患者に対する専門家による口腔ケア管理プログラムの効果。12ヵ月間の追跡調査

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J Dent Sci.2021 Jan;16(1):453-459. S1991-7902(20)30215-4. doi: 10.1016/j.jds.2020.09.010.Epub 2020-10-03.

放射線治療後の頭頸部がん患者に対する専門家による口腔ケア管理プログラムの効果。12ヵ月間の追跡調査

Effects of the professional oral care management program on patients with head and neck cancer after radiotherapy: A 12-month follow-up.

Hae-Ok Sohn
Eun-Young Park
Yun-Sook Jung
Joo-Young Lee
Eun-Kyong Kim

PMID: 33384834 PMCID: PMC7770362. DOI: 10.1016/j.jds.2020.09.010.

抄録

背景・目的:

Background/purpose: Because oral health of patients with head & neck cancer is prone to disease after radiotherapy, effective and long-lasting oral care program is necessary. We aimed to evaluate the effects of the oral care management program, which lasted up to 12 months after radiotherapy for patients with head and neck cancer.

材料と方法:

放射線治療開始前に歯科医院を受診した68名の患者を募集し、「健常者群」と「脆弱者群」に分類した。脆弱群は，う蝕や歯根膜付着の欠損がある患者で構成された。放射線治療中は1ヶ月間毎週1回、放射線治療後は3ヶ月に1回、歯磨き指導、専門家による機械的歯面清掃、フッ化物ワニス塗布などの専門的口腔衛生ケアを行った。虫歯，プラーク，歯肉指数，歯根膜付着量などの口腔衛生状態を，放射線治療の開始前，6ヵ月後，12ヵ月後に調査した。

Materials and methods: Sixty-eight patients who visited a dental clinic prior to the initiation of radiotherapy were recruited and categorized into either a "healthy" or a "vulnerable" group. The vulnerable group was made of patients with dental caries or periodontal attachment loss. Professional oral hygiene care, including tooth brushing instructions, professional mechanical tooth cleaning, and fluoride varnish application, was conducted once every week for a month during radiotherapy and once every 3 months after radiotherapy. Oral health, including dental caries, plaques, gingival index, and periodontal attachment loss, was examined at baseline, 6 months, and 12 months after radiotherapy.

結果:

放射線治療後6ヵ月目に29名、12ヵ月目に16名の患者が追跡調査を受けた。むし歯の数，歯垢の量，歯肉指数などの口腔衛生指標は，両群ともに有意な変化は認められなかった。しかし、歯周ポケットの深さはベースラインから6ヵ月後に両群で有意に減少し、この減少は脆弱な群でベースラインから12ヵ月後まで続いた。

Results: ; Twenty-nine and 16 patients were followed up at 6 and 12 months after radiotherapy, respectively. Oral health indices, such as the number of decayed teeth, amount of plaque, and gingival index, did not significantly change in either group. However, the periodontal pocket depth significantly decreased in both groups at 6 months after baseline, and this decrease continued in the vulnerable group up to 12 months after baseline.

結論:

放射線治療中および放射線治療後の定期的な歯科受診と専門的な口腔衛生ケアは、頭頸部がん患者の放射線治療後12カ月以上の口腔衛生の維持に有効であった。

Conclusion: Periodic dental visits and professional oral hygiene care during and after radiotherapy were effective in maintaining oral health for over 12 months after radiotherapy in patients with head and neck cancer.