Архив номеров
Остеорадионекроз лицевого черепа: современные доказательные данные (обзор литературы)
DOI: 10.21870/0131-3878-2023-32-2-142-156
Полькин В.В.1, Исаев П.А.1, Плугарь А.К.1, Ильин А.А.1, Рожнов В.А.1, Спирин П.И.1, Панасейкин Ю.А.1, Иванов С.А.1,3, Каприн А.Д.2,3,4
«Радиация и риск». 2023. Том 32. № 2, с.142-156
Сведения об авторах
Полькин В.В. – зав. отд., к.м.н. Контакты: 249035, Калужская обл., Обнинск, ул. Королёва, 4. Тел.: +79108637283; e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .
Исаев П.А. – вед. науч. сотр., д.м.н. Плугарь А.К. – врач-онколог, аспирант Ильин А.А. – вед. науч. сотр., д.м.н. Рожнов В.А. – вед. науч. сотр., д.м.н. Спирин П.И. – мл. науч. сотр. Панасейкин Ю.А. – мл. науч. сотр. Иванов С.А. – директор, чл.-корр. РАН, д.м.н., проф. кафедры РУДН. МРНЦ им. А.Ф. Цыба – филиал ФГБУ «НМИЦ радиологии» Минздрава России. Каприн А.Д. – ген. директор, директор МНИОИ им. П.А. Герцена, зав. каф. РУДН, акад. РАН, д.м.н., проф. ФГБУ «НМИЦ радиологии» Минздрава России. 1 МРНЦ им. А.Ф. Цыба – филиал ФГБУ «НМИЦ радиологии» Минздрава России, Обнинск2 ФГБУ «НМИЦ радиологии» Минздрава России, Обнинск
3 ФГАОУ ВО «Российский университет дружбы народов», Москва
4 МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИЦ радиологии» Минздрава России, Москва
Аннотация
Несмотря на последние достижения в лучевой терапии, у многих пациентов с опухолями головы и шеи, прошедших курс радиотерапии, возникает тяжёлое осложнение – остеорадионекроз. Современные методы лечения остеорадионекроза разработаны с учётом сложности патофизиологии заболевания и теорий патогенеза. В настоящее время рассматривают следующие теории патофизиологии остеорадионекроза: радиационно-индуцированный остеомиелит, гипоксическая, гиповаскулярная и фиброатрофическая теории. До проведения лучевой терапии больному проводят восстановительное стоматологическое лечение и планирование лучевой терапии. Способы лечения варьируют от консервативных «наблюдай и жди» до более радикальных хирургических вмешательств. В настоящее время не существует доказательного стандарта оказания помощи больным остеорадионекрозом, хотя поиски в этом направлении активно ведутся. Новейшие лечебные стратегии доступны с ограниченной доказательной базой. Целью данного обзора является оценка литературы, касающейся остеорадионекроза челюсти, с акцентом на доступные варианты лечения.
Ключевые слова
классификация, рак головы и шеи, остеорадионекроз, патофизиология, лечение, лучевая терапия, обзор, теории патогенеза, злокачественное новообразование, радиотерапия с модуляцией интенсивности.
Список цитируемой литературы
1. Терапевтическая радиология: национальное руководство /под ред. А.Д. Каприна, Ю.С. Мардынского. М: ГэотарМедиа, 2018. 704 с.
2. Reuther T., Schuster T., Mende U., Kubler A. Osteoradionecrosis of the jaws as a side effect of radiotherapy of head and neck tumour patients – a report of a thirty year retrospective review //Int. J. Oral Maxillofac. Surg. 2003. V. 32, N 3. P. 289-295.
3. Shaw R.J., Dhanda J. Hyperbaric oxygen in the management of late radiation injury to the head and neck. Part I: treatment //Br. J. Oral Maxillofac. Surg. 2011. V. 49, N 1. P. 2-8.
4. He Y., Liu Z., Tian Z., Dai T., Qiu W., Zhang Z. Retrospective analysis of osteoradionecrosis of the mandible: proposing a novel clinical classification and staging system //Int. J. Oral Maxillofac. Surg. 2015. V. 44, N 12. P. 1547-1557.
5. Store G., Boysen M. Mandibular osteoradionecrosis: clinical behaviour and diagnostic aspects //Clin. Otolaryngol. Allied Sci. 2000. V. 25, N 5. P. 378-384.
6. Beumer J.3rd, Silverman S.Jr., Benak S.B.Jr. Hard and soft tissue necroses following radiation therapy for oral cancer //J. Prosthet. Dent. 1972. V. 27, N 6. P. 640-644.
7. Epstein J.B., Wong F.L., Dickens A., Szasz I., Lepawsky M. Bone and gallium scans in postradiotherapy osteonecrosis of the jaw //Head Neck. 1992. V. 14, N 4. P. 288-292.
8. Marx R.E. A new concept in the treatment of osteoradionecrosis //J. Oral Maxillofac. Surg. 1983. V. 41, N 6. P. 351-357.
9. Beumer J.3rd, Harrison R., Sanders B., Kurrasch M. Postradiation dental extractions: a review of the literature and a report of 72 episodes //Head Neck Surg. 1983. V. 6, N 1. P. 581-586.
10. Harris M. The conservative management of osteoradionecrosis of the mandible with ultrasound therapy //Br. J. Oral Maxillofac. Surg. 1992. V. 30, N 5. P. 313-318.
11. Schwartz H.C., Kagan A.R. Osteoradionecrosis of the mandible: scientific basis for clinical staging //Am. J. Clin. Oncol. 2002. V. 25, N 2. P. 168-171.
12. Notani K., Yamazaki Y., Kitada H., Sakakibara N., Fukuda H., Omori K., Nakamura M. Management of mandibular osteoradionecrosis corresponding to the severity of osteoradionecrosis and the method of radio-therapy //Head Neck. 2003. V. 25, N 3. P. 181-186.
13. Nabil S., Samman N. Risk factors for osteoradionecrosis after head and neck radiation: a systematic review //Oral Surg. Oral Med. Oral Pathol. Oral Radiol. 2012. V. 113, N 1. P. 54-69.
14. Jiang Y.-m., Zhu X.-d., Qu S. Incidence of osteoradionecrosis in patients who have undergone dental extraction prior to radiotherapy: a systematic review and meta-analysis //J. Oral Maxillofac. Surg. Med. Pathol. 2014. V. 26, N 3. P. 269-275.
15. Wang T.H., Liu C.J., Chao T.F., Chen T.J., Hu Y.W. Risk factors for and the role of dental extractions in osteoradionecrosis of the jaws: a national-based cohort study //Head Neck. 2017. V. 39, N 7. P.1313-1321.
16. Kluth E.V., Jain P.R., Stuchell R.N., Frich J.C.Jr. A study of factors contributing to the development of osteoradionecrosis of the jaws //J. Prosthet. Dent. 1988. V. 59, N 2. P. 194-201.
17. David L.A., Sandor G.K., Evans A.W., Brown D.H. Hyperbaric oxygen therapy and mandibular osteo-radi-onecrosis: a retrospective study and analysis of treatment outcomes //J. Can. Dent. Assoc. 2001. V. 67, N 7. P. 384.
18. Shaw R.J., Butterworth C. Hyperbaric oxygen in the management of late radiation injury to the head and neck. Part II: prevention //Br. J. Oral Maxillofac. Surg. 2011. V. 49, N 1. P. 9-13.
19. Hehr T., Classen J., Welz S., Ganswindt U., Scheithauer H., Koitschev A., Bamberg M., Budach W. Hyperfractionated, accelerated chemoradiation with concurrent mitomycin-C and cisplatin in locally advanced head and neck cancer, a phase I/II study //Radiother. Oncol. 2006. V. 80, N 1. P. 33-38.
20. Studer G., Studer S.P., Zwahlen R.A., Huguenin P., Grätz K.W., Lütolf U.M., Glanzmann C. Osteoradio-necrosis of the mandible: minimized risk profile following intensity-modulated radiation therapy (IMRT) //Strahlenther. Onkol. 2006. V. 182, N 5. P. 283-288.
21. Teng M.S., Futran N.D. Osteoradionecrosis of the mandible //Curr. Opin. Otolaryngol. Head Neck Surg. 2005. V. 13, N 4. P. 217-221.
22. Lyons A.J., West C.M., Risk J.M., Slevin N.J., Chan C., Crichton S., Rinck G., Howell D., Shaw R.J. Osteoradionecrosis in head-and-neck cancer has a distinct genotype-dependent cause //Int. J. Radiat. Oncol. Biol. Phys. 2012. V. 82, N 4. P. 1479-1484.
23. Leemans C.R., Braakhuis B.J., Brakenhoff R.H. The molecular biology of head and neck cancer //Nat. Rev. Cancer. 2011. V. 11, N 1. P. 9-22.
24. Cutler M. The problem of extractions in relation to osteoradionecrosis complicating radiotherapy for intraoral cancer //Oral Surg. Oral Med. Oral Pathol. 1951. V. 4, N 9. P. 1077-1090.
25. Meyer I. Infectious diseases of the jaws //J. Oral Surg. 1970. V. 28, N 1. P. 17-26.
26. Titterington W.P. Osteomyelitis and osteoradionecrosis of the jaws //J. Oral Med. 1971. V. 26, N 1. P. 7-16.
27. Gowgiel J.M. Experimental radio-osteonecrosis of the jaws //J. Dent. Res. 1960. V. 39. P. 176-197.
28. Rudolph R., Tripuraneni P., Koziol J.A., McKean-Matthews M., Frutos A. Normal transcutaneous oxygen pressure in skin after radiation therapy for cancer //Cancer. 1994. V. 74, N 11. P. 3063-3070.
29. Delanian S., Lefaix J.L. The radiation-induced fibroatrophic process: therapeutic perspective via the anti-oxidant pathway //Radiother. Oncol. 2004. V. 73, N 2. P. 119-131.
30. Vozenin-Brotons M.C., Milliat F., Sabourin J.C., de Gouville A.C., François A., Lasser P., Morice P., Haie-Meder C., Lusinchi A., Antoun S., Bourhis J., Mathé D., Girinsky T., Aigueperse J. Fibrogenic signals in patients with radiation enteritis are associated with increased connective tissue growth factor expression //Int. J. Radiat. Oncol. Biol. Phys. 2003. V. 56, N 2. P. 561-572.
31. Dambrain R. The pathogenesis of osteoradionecrosis //Rev. Stomatol. Chir. Maxillofac. 1993. V. 94, N 3. P. 140-147.
32. Niezgoda J.A., Serena T.E., Carter M.J. Outcomes of radiation injuries using hyperbaric oxygen therapy: an observational cohort study //Adv. Skin Wound Care. 2016. V. 29, N 1. P. 12-19.
33. Peterson D.E., Doerr W., Hovan A., Pinto A., Saunders D., Elting L.S., Spijkervet F.K., Brennan M.T. Osteoradionecrosis in cancer patients: the evidence base for treatment-dependent frequency, current management strategies, and future studies //Support Care Cancer. 2010. V. 18, N 8. P. 1089-1098.
34. Studer G., Bredell M., Studer S., Huber G., Glanzmann C. Risk profile for osteoradionecrosis of the mandi-ble in the IMRT era //Strahlenthe.r Onkol. 2016. V. 192, N 1. P. 32-39.
35. Owosho A.A., Tsai C.J., Lee R.S., Freymiller H., Kadempour A., Varthis S., Sax A.Z., Rosen E.B., Yom S.K., Randazzo J., Drill E., Riedel E., Patel S., Lee N.Y., Huryn J.M., Estilo C.L. The prevalence and risk factors associated with osteoradionecrosis of the jaw in oral and oropharyngeal cancer patients treated with intensity-modulated radiation therapy (IMRT): the Memorial Sloan Kettering Cancer Center experience //Oral Oncol. 2017. V. 64. P. 44-51.
36. De Felice F., Musio D., Tombolini V. Osteoradionecrosis and intensity modulated radiation therapy: an overview //Crit. Rev. Oncol. Hematol. 2016. V. 107. P. 39-43.
37. Gomez D.R., Estilo C.L., Wolden S.L., Zelefsky M.J., Kraus D.H., Wong R.J., Shaha A.R., Shah J.P., Mechalakos J.G., Lee N.Y. Correlation of osteoradionecrosis and dental events with dosimetric parameters in intensity-modulated radiation therapy for head-and-neck cancer //Int. J. Radiat. Oncol. Biol. Phys. 2011. V. 81, N 4. P. 207-213.
38. Eisbruch A., Ten Haken R.K., Kim H.M., Marsh L.H., Ship J.A. Dose, volume, and function relationships in parotid salivary glands following conformal and intensity-modulated irradiation of head and neck cancer //Int. J. Radiat. Oncol. Biol. Phys. 1999. V. 45, N 3. P. 577-587.
39. Deasy J.O., Moiseenko V., Marks L., Chao K.S., Nam J., Eisbruch A. Radiotherapy dose-volume effects on salivary gland function //Int. J. Radiat. Oncol. Biol. Phys. 2010. V. 76, N 3. P. 58-63.
40. Tsai C.J., Hofstede T.M., Sturgis E.M., Garden A.S., Lindberg M.E., Wei Q., Tucker S.L., Dong L. Osteoradionecrosis and radiation dose to the mandible in patients with oropharyngeal cancer //Int. J. Radiat. Oncol. Biol. Phys. 2013. V. 85, N 2. P. 415-420.
41. Marx R.E., Johnson R.P., Kline S.N. Prevention of osteoradionecrosis: a randomized prospective clinical trial of hyperbaric oxygen versus penicillin //J. Am. Dent. Assoc. 1985. V. 111, N 1. P. 49-54.
42. Kanatas A.N., Lowe D., Harrison J., Rogers S.N. Survey of the use of hyperbaric oxygen by maxillofacial oncologists in the UK //Br. J. Oral Maxillofac. Surg. 2005. V. 43, N 3. P. 219-225.
43. Epstein J., van der Meij E., McKenzie M., Wong F., Lepawsky M., Stevenson-Moore P. Postradiation osteonecrosis of the mandible: a long-term follow-up study //Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 1997. V. 83, N 6. P. 657-662.
44. Gal T.J., Yueh B., Futran N.D. Influence of prior hyperbaric oxygen therapy in complications following microvascular reconstruction for advanced osteoradionecrosis //Arch. Otolaryngol. Head Neck Surg. 2003. V. 129, N 1. P. 72-76.
45. Lee M., Chin R.Y., Eslick G.D., Sritharan N., Paramaesvaran S. Outcomes of microvascular free flap reconstruction for mandibular osteoradionecrosis: a systematic review //J. Craniomaxillofac. Surg. 2015. V. 43, N 10. P. 2026-2033.
46. Mainous E.G., Boyne P.J., Hart G.B. Elimination of sequestrum and healing of osteoradionecrosis of the mandible after hyperbaric oxygen therapy: report of case //J. Oral Surg. 1973. V. 31, N 5. P. 336-339.
47. Sulaiman F., Huryn J.M., Zlotolow I.M. Dental extractions in the irradiated head and neck patient: a retro-spective analysis of Memorial Sloan-Kettering Cancer Center protocols, criteria, and end results //J. Oral Maxillofac. Surg. 2003. V. 61, N 10. P. 1123-1131.
48. McKenzie M.R., Wong F.L., Epstein J.B., Lepawsky M. Hyperbaric oxygen and postradiation osteonecrosis of the mandible //Eur. J. Cancer B Oral Oncol. 1993. V. 29B, N 3. P. 201-207.
49. Mounsey R.A., Brown D.H., O’Dwyer T.P., Gullane P.J., Koch G.H. Role of hyperbaric oxygen therapy in the management of mandibular osteoradionecrosis //Laryngoscope. 1993. V. 103, N 6. P. 605-608.
50. Dhanda J., Durrani L., Beshara E., Machon L., Parmar S. Comparisons between UK and European proto-cols used in the treatment of osteoradionecrosis with hyperbaric oxygen therapy //Br. J. Oral Maxillofac. Surg. 2009. V. 47, N 7. P. e25-e26.
51. Dhanda J., Hall T.J., Wilkins A., Mason V., Catling J. Patterns of treatment of osteoradionecrosis with hyperbaric oxygen therapy in the United Kingdom //Br. J. Oral Maxillofac. Surg. 2009. V. 47, N 3. P. 210-213.
52. Shaw R., Forner L., Butterworth C., Jansen E., Hillerup S., Nutting C., Overgaard J. Randomised controlled trials in HBO: “A call to arms” for HOPON & DAHANCA-21 //Br. J. Oral Maxillofac. Surg. 2011. V. 49, N 1. P. 76-77.
53. Bennett M.H., Feldmeier J., Hampson N., Smee R., Milross C. Hyperbaric oxygen therapy for late radiation tissue injury //Cochrane Database Syst. Rev. 2012. V. 4, N 4. P. CD005005.
54. Delanian S., Depondt J., Lefaix J.L. Major healing of refractory mandible osteoradionecrosis after treatment combining pentoxifylline and tocopherol: a phase II trial //Head Neck. 2005. V. 27, N 2. P. 114-23.
55. Delanian S. Striking regression of radiation-induced fibrosis by a combination of pentoxifylline and toco-pherol //Br. J. Radiol. 1998. V. 71, N 848. P. 892-894.
56. Delanian S., Porcher R., Balla-Mekias S., Lefaix J.L. Randomized, placebo-controlled trial of combined pentoxifylline and tocopherol for regression of superficial radiation-induced fibrosis //J. Clin. Oncol. 2003. V. 21, N 13. P. 2545-2550.
57. Patel V., Gadiwalla Y., Sassoon I., Sproat C., Kwok J., McGurk M. Prophylactic use of pentoxifylline and tocopherol in patients who require dental extractions after radiotherapy for cancer of the head and neck //Br. J. Oral Maxillofac. Surg. 2016. V. 54, N 5. P. 547-550.
58. Delanian S., Chatel C., Porcher R., Depondt J., Lefaix J.L. Complete restoration of refractory mandibular osteoradionecrosis by prolonged treatment with a pentoxifylline-tocopherol-clodronate combination (PENTOCLO): a phase II trial //Int. J. Radiat. Oncol. Biol. Phys. 2011. V. 80, N 3. P. 832-839.
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