下颌骨缺损钛板修复后的放射治疗

Radiotherapy for immediate reconstruction of mandibular defects with the titanium plate after tumor resection of mandible

目的观察放疗对口腔癌根治术后下颌骨缺损钛板即刻修复的影响.方法对1997年1月至2002年5月58例下颌骨缺损钛板修复患者的放疗反应、并发症观察分析,并分析研究影响钛板修复的因素.放疗组30例,放疗剂量4 050～6 540 cGy(平均5 495 cGy),钛板在放射野内受到全程照射.结果放疗组6例局部感染和瘘管形成,5例钛板外露;对照组4例局部感染和瘘管形成,3例钛板外露.放疗组6例、对照组4例因局部感染在术后4～15个月手术取出钛板,术后放疗组下颌骨缺损钛板立即修复成功率为80.0%(24/30),对照组为85.7%(24/28).两组差异无统计学意义(P>0.05).结论下颌骨缺损钛板修复后可以进行放疗.

Objective To study the influence of radiotherapy on immediate reconstruction with the titanium plate after resection of mandible in oral cancer patients.Methods Fifty eight cases (radiation group, 30 patients and control group, 28 patients) with titanium plate for immediate reconstruction of mandibular defects were observed from January, 1997 to May, 2002. The patients of radiation group underwent radiotherapy with total doses of 4 050 6 540 cGy ( mean 5 495 cGy). The titanium plate was in radiation fields and was irradiated during the radiation therapy.Results Localinfection and fistula accounted for 6 cases and plate exposure accounted for 5 in radiation group. Local infection and plate exposure happened in 4 and 3 patients in control group respectively. Titanium plates were taken in six cases in radiation group and 4 cases in control group by re surgery 4 15 months after primary surgery because of local infection. The success rates of immediate reconstruction with the titanium plate were 80 0 % (24/30) in radiation group and 85 7 %(24/28) in control group ( P >0 05).Conclusions The cases of immediate reconstruction with the titanium plate after resection of mandible in oral cancer patients can accept postoperative radiotherapy.