有关颌骨放射性骨坏死治疗中文文献的系统性评价

Systematic evaluation of Chinese literatures on therapy of osteoradionecrosis of the jaws

目的:颌骨放射性骨坏死是头颈部恶性肿瘤放射治疗的严重并发症,拟对中文文献中的防治方法进行复习和评价。方法:收集20年来所有关于颌骨放射性骨坏死治疗的中文文献,应用系统评价的方法学进行评估。结果:共收集21篇相关文献,计 384例患者。保守治疗 21例,治愈率28.57%,保守治疗配合高压氧治疗 92例,治愈率 19.57%,单纯死骨摘除 48例,治愈率 29.17%,单纯截骨治疗 75例,治愈率 93.24%,死骨摘除配合高压氧治疗77例,治愈率 77.92%,截骨配合高压氧治疗 43例,治愈率90.7%。结论:一旦颌骨放射性骨坏死发生,要积极进行手术治疗,宜以手术截骨术治疗为主,高压氧治疗辅助可进一步提高疗效。

AIM: Osteoradionecrosis of the jaws (ORNJ) is one of the severe complications after radiotherapy for malignant tumors of the caput and cervical part. The present study aimed to review and evaluate the effective treatments for ORNJ in Chinese literatures. METHODS:All vicennial Chinese literatures on therapy of ORNJ were collected and evaluated with evaluation methodology. RESULTS:Totally 21 articles were collected in which 384 cases were included.The conservative treatment,conservative and hyperbaric oxygen (HBO),sequestrectomy, osteotomy,sequestrectomy and HBO,osteotomy and HBO were performed in 21,92,48,75,77 and 43 cases respectively, and the cure rates were 28.57%,19.57%,29.17%,93.24%,77.92%, 90.7%respectively. CONCLUSION:Once ORNJ occurs, operation should be made actively. Osteotomy plays a major role and assistant hyperbaric oxygen can enhance the effect ulteriorly.