头颈部肿瘤患者放射性龋相关性因素分析

doi:10.7518/hxkq.2019.01.017

摘要/Abstract

摘要：

目的通过构建多元线性回归方程探讨放射性龋相关危险因素,为有效预防放射性龋提供依据。方法收集166例头颈部肿瘤放射治疗后患者,记录其患龋情况（龋失补牙面数）及个人相关信息（包括年龄、性别、放射治疗的方式和剂量等）,并进行多元逐步回归分析。结果放射性龋的危险因素依次为：菌斑指数、放射治疗的方式、放射治疗后时间和放射治疗的剂量。结论增强头颈部肿瘤患者的口腔卫生保健意识,尽量采用适形调强放射治疗技术,在有效控制肿瘤的情况下尽可能降低头颈部的放射治疗剂量等措施可减少放射性龋的发生。

关键词: 头颈部肿瘤, 放射性龋, 危险因素

Abstract:

Objective This study aimed to evaluate the risk factors of radiation-induced caries by using a multiple linear regression equation and to provide the basis for the effective prevention of radioactive caries. Methods A total of 166 patients with head and neck cancer who underwent radiotherapy were selected as subjects. The number of decayed, missing or filled surfaces were recorded. Questionnaire contents included age, sex, radiation dose, and radiotherapy techniques. Multiple step-wise regression analyses were performed to identify the risk factors of radiation-induced caries. Results Multiple stepwise regression analyses indicated that the main risk factors of radiation-induced caries were plaque index, radiotherapy techniques, time after radiotherapy, and radiotherapy dose. Conclusion The awareness of dental care and caries treatment should be improved to reduce the occurrence of radiation-induced caries in patients with head and neck cancer. In addition, intensity modulated radiation therapy should be employed to decrease the radiation exposure dose received by teeth.

Key words: head and neck cancer, radiation-induced caries, risk factors

中图分类号:

R 781.1

吴莉玲,高清平,扶琼瑶,耿坤. 头颈部肿瘤患者放射性龋相关性因素分析[J]. 华西口腔医学杂志, 2019, 37(1): 87-91.

Liling Wu,Qingping Gao,Qiongyao Fu,Kun. Geng. Analysis of the risk factors of radiation-induced caries in patients with head and neck cancer[J]. West China Journal of Stomatology, 2019, 37(1): 87-91.

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参考文献 34

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因素	变量名	编码说明
性别	X₁	1=男,2=女
年龄	X₂	按实际年龄填写
放疗后时间	X₃	按实际放疗后时间填写
肿瘤性质	X₄	1=鼻咽癌,2=淋巴瘤,3=咽喉癌,4=口腔癌,5=唾液腺肿瘤,6=上颌窦癌,7=筛窦癌
T分期	X₅	1=T1,2=T2,3=T3,4=T4
N分期	X₆	1=N1,2=N2,3=N3
M分期	X₇	0=M1,1=M2
放疗剂量	X₈	按实际放疗剂量填写
放疗方式	X₉	1=适形调强放疗（intensity modulated radiation therapy,IMRT）,2=常规放疗
联合化疗	X₁₀	1=是,2=否
氟化物摄入	X₁₁	1=无,2=使用含氟牙膏,3=涂氟治疗
每日刷牙次数	X₁₂	按实际次数填写
每次刷牙时间	X₁₃	1=≤1 min,2=>1 min且<3 min,3=≥3 min
刷牙态度	X₁₄	1=不太仔细,2=比较仔细,3=非常仔细（采用巴氏刷牙法）
吸烟	X₁₅	1=经常,2=较少,3=无
饮酒	X₁₆	1=经常,2=较少,3=无
喜进甜食	X₁₇	1=经常,2=较少,3=无
睡前进食	X₁₈	1=经常,2=较少,3=无
全身系统性疾病	X₁₉	1=有,2=常有小病,3=偶有小病
菌斑指数	X₂₀	0=龈缘区无菌斑;1=龈缘区的牙面有薄的菌斑,但视诊不可见,若用探针尖的侧面可刮
		出菌斑;2=在龈缘或邻面可见中等量菌斑;3=龈沟内或龈缘区及邻面有大量软垢及菌斑
DMFS	Y	龋失补牙面数（decayed, missing or filled surfaces,DMFS）

危险因素	回归系数	回归系数标准误	t值	P值
常量	-35.817	8.197	-4.370	0.000
X₂₀菌斑指数	8.278	0.910	9.097	0.000
X₉放疗方式	7.184	1.292	5.559	0.000
X₃放疗后时间	1.006	0.314	3.201	0.002
X₈放疗剂量	0.316	0.120	2.633	0.009