烟酰胺和胃复安对恶性肿瘤放疗化疗的增敏作用

烟酰胺和胃复安是近年国外学者研究较多的放疗、化疗增敏剂。它们对体外培养的恶性肿瘤细胞、鼠类肿瘤以及人类恶性肿瘤的异种移植物均有显著的放疗、化疗增敏作用。其机理主要是通过改善肿瘤组织血供,提高肿瘤组织的氧合程度,抑制DNA损伤的修复而提高放疗、化疗效果。     

细胞凋亡在头颈部肿瘤放射治疗中的作用

<正>放射治疗是对头颈部肿瘤常用的治疗手段。但部分肿瘤对放疗不敏感,而且正常组织有时会出现较严重的损伤,这些限制了放疗的应用。虽然一些新的方法和技术被用于放疗,如放疗增敏剂、计算机辅助设计治疗方案等,但放疗效果的主要障碍,即肿瘤的放射抵抗和正常组织的放射损伤仍然未被克服。     

烟酰胺和胃复安对恶性肿瘤放疗化疗的增敏作用

烟酰胺和胃复安是近年国外学者研究较多的放疗，化疗增敏剂。它们对体外培养的恶性肿瘤细胞，鼠类肿瘤以及人类恶性肿瘤的异种移植物均有显著的放疗，化疗增效作用。其机理主要是通过改善肿瘤以及人类恶性肌瘤的异种移植物均有显著的放疗，化疗增敏作用。其机理主要是通过改善肿瘤组织血，提高肿瘤组织的氧合程度，抑制ＤＮＡ损伤的修复而提高放疗，化疗效果。     

头颈部肿瘤的间质近距放射治疗

放疗在头颈部肿瘤的治疗中起重要作用,头颈部晚期和复发性肿瘤的再次放疗受正常组织对辐射的耐受性影响,难以达到治疗剂量.间质放疗是将放射性同位素直接置入肿瘤组织内,对肿瘤组织施以较高的辐射剂量,而对正常组织的影响较小.本文介绍间质放疗在临床上的应用及疗效,认为其与常规外束流放疗结合,可提高肿瘤局部控制率和生存率.     

高温疗法的热增敏剂研究进展

高温治疗恶性肿瘤在近十年内取得了令人鼓舞的成就,被称为是继手术、放疗、化疗和免疫疗法之后的第五种治疗恶性肿瘤的方法。单纯的高温治疗恶性肿瘤的临床效果并不能令人满意,已发现一类物质,它在正常体温状态下对癌细胞无杀伤作用,而在高温下变为对癌细胞有杀伤作用或促进高温对癌细胞的杀伤作用,这类物质称为热增敏剂。本文就热增敏剂的种类、抗癌效果、作用机制、临床应用前景及今后的研究方向作了全面的阐述。     

热疗联合化疗治疗口腔癌60例：兼论高糖的热增敏作用

热疗(Hyperthermia)治癌已有百余年历史,国内、外动物实验证明其有效后,近10余年才较多用于治疗癌肿病人。单纯热疗治癌的效果不及联合放疗或化疗为佳,而联合热增敏剂更显示其独特的效果。用高糖作为热增敏剂联合热化疗治癌,尚未见报道。 我们自1985年11月至1990年4月,采用     

三联药物动脉灌注与放疗、手术联合治疗头颈部癌

对各期口腔鳞癌的治疗,目前五年生存率最高仅达50%,越是晚期,生存率越是显著减少。局部复发是治疗失败的主要标志。动脉灌注化学药物可使30—50%病例的肿瘤缩小,其中15%病例的肿瘤完全消退。现已证实,联合用药比单独用药效果好。放疗联合手术治疗比单独手术治疗效果好。区域灌注化学药物之后进行放疗可使肿瘤的消退增     

头颈部肿瘤的间质近距放射治疗

放疗在头颈部肿瘤的治疗中起重要作用,头颈部晚期和复发性肿瘤的再次放疗受正常组织对辐射的耐受性影响,难以达到治疗剂量。间质放疗是将放射性同位素直接置入肿瘤组织内,对肿瘤组织施以较高的辐射剂量, 而对正常组织的影响较小。本文介绍间质放疗在临床上的应用及疗效,认为其与常规外束流放疗结合,可提高肿瘤局部控制率和生存率。     

口腔颌面部恶性肿瘤的热放疗

口腔颌面部恶性肿瘤的热放疗王中和热放疗即热疗与放疗联合应用治疗肿瘤的方法近２０多年来，由于肿瘤热疗设备的发展、细胞和分子水平的热生物学研究进展，以及热放疗在实验室和临床应用已取得令人鼓舞的成果，使其成为恶性肿瘤治疗的新手段受到重视。口腔颌面部恶性肿瘤...     

局部热疗在头颈癌综合治疗中的应用

本文综述了当今热疗联合放、化疗在头颈癌治疗中的应用情况。温热(40～44℃)能显著增加放疗和(或)化疗的疗效,并在多方面具有合理性。加热技术的改进确保了有效的加热深度和精确的加热温度。温热的抗肿瘤机理是诱导肿瘤细胞凋亡,多项临床试验取得了令人鼓舞的结果。局部热疗的主要不良反应是皮肤的急性烫伤水泡、溃疡或不适(疼痛)。当联合放、化疗时,全身的不良反应主要是可接受的中度血液毒性和轻度胃肠道毒性。组织氧和度、p53、Hsp表达等参数可以预测热疗的效果。影响热疗疗效的因素包括热耐受情况、热增敏剂的应用、均匀加热以及有效的治疗温度等。随着肿瘤综合序列治疗概念的建立,热疗在头颈癌辅助治疗中将起到越来越重要的作用。     

Statistical analysis on oral cancer patients related to radiotherapy

Summary Sixty nine patients with carcinoma of the oral cavity, especially those treated by radiotherapy during the 5 year period from 1982 through 1987 were reviewed. Sixty three of 67 patients (94%) had received radiation therapy with curative, adjunctive or palliative intent. In the cases when external irradiation was applied, the antitumor agents were combined in most cases. As the curative therapy for tongue cancer, 23 of 33 patients were treated with radiotherapy alone, i.e., interstitial implants alone or in combination with external irradiation. The 5-year cumulative survival rate for all cases was 55.4%; for stage I and II was 84%, and for stage III and IV it was 22.7%.     

Boron neutron capture therapy as a novel modality of radiotherapy for oral cancer: Principle and antitumor effect

Radiotherapy is essential for the treatment of oral cancer, especially in advanced cases. There has been marked progress in this field due to the prevalence of intensity-modified radiation therapy and introduction of particle radiotherapy using protons and carbon-ions. However, these treatments are still non-selective. Boron neutron capture therapy (BNCT) is a unique modality in which neutron beams destroy only boron compound-bearing tumor cells while leaving the surrounding normal tissues intact. Thus, BNCT is a selective form of radiotherapy, if high tumor/normal tissue ratio in boron concentration could be achieved. The principle of BNCT, and the basic study of the mechanism by which BNCT exerts antitumor effects using oral squamous cell carcinoma (SCC) cells and oral SCC xenografts in mice are described.     

高压氧对种植后颌骨放疗的影响

目的 探讨高压氧对种植后放疗的恢复治疗作用。方法 通过兔胫骨骨内植入纯钛植入体，建立植入体骨整合的动物模型，并在此基础上进行放疗，对种植后颌骨放疗进行高压氧恢复治疗，通过形态学观察和骨计量学参数的测定。结果 实验结果表明高压氧治疗可促进种植区骨质生成，控制放射损伤，缩短放射损伤恢复时间。结论 高压氧可作为种植后放疗患者的辅助治疗。     

颌下腺转位预防放射性口干的初步研究

目的评价颌下腺转位于颏下间隙后腺体功能及预防头颈部放疗导致的口干的效果。方法将3例头颈癌患者的颌外动脉和面前静脉近心端切断，保留该动静脉的远心端，并将其作为蒂，游离颌下腺后将其转位于颏下间隙。颈部放疗时屏蔽转住的颌下腺。术前术后以及放疗后检测颌下腺唾液流量，并填写华盛顿大学生活质量调查表。结果通过唾液流量分析，3例转住的颌下腺均成活。其中2例经放疗后20个月随访的患者，转住的颌下腺保存一定的泌唾功能，患者无口干症状。结论颌下腺转位于颏下区可保存其功能，有助于预防头颈癌患者放疗导致的口干。     

晚期头颈鳞癌：术前放疗还是术后放疗？

晚期头颈鳞癌是采用术前放疗还是术后放疗,长期以来争议不断,给许多患者造成不必要的经济负担和身心痛苦,甚至失去了最佳治疗时机。根据美国肿瘤放疗协作组以及我科的研究结果,我们认为,对于晚期头颈鳞癌,术后放疗优于术前放疗。术后6周内给予60Gy的放射治疗,可以成为晚期头颈鳞癌治疗的金标准。     

Use of nanomaterials in dentistry: covariates of risk and benefit perceptions among dentists and dental hygienists in Norway

Abstract

Objective: Focusing dentists and dental hygienists employed in the Public Dental Health Services (PDHSs) in Norway, this study set out to assess whether socio-demographic factors, familiarity with nanotechnology and social trust are associated with dental health care workers’ perceived risks and benefits of use of nanomaterials in dentistry and whether those associations varied according to professional status. It was hypothesized that increased knowledge, trust in stakeholders and familiarity with nanomaterials would decrease the risk and increase benefit perceptions among dental health care workers.

Methods: Electronic questionnaires were administered to a census of 1792 dentists and dental hygienists.

Results: About 64% and 69% of respondents perceived respectively, risk and benefits associated with use of nanomaterials. Multiple variable logistic regression revealed that dentists were more likely than hygienists to perceive risks (OR = 1.9, 95% CI 1.1–3.3) and benefits (OR = 3.6, 95% CI 2.1–6.2). Having experience with dental nanomaterials (OR = 2.2, 95% CI 1.3–3.7) and feeling safe (OR = 6.6, 95% CI 3.1–14.2) increased perceived benefits. Having moderate or much correct knowledge about nanotechnology (OR = 2.3, 95% CI 1.5–3.5) increased the likelihood of perceived risk.

Conclusions: Policy makers should consider the factors that influence dental health care workers’ risk and benefit perceptions associated with the use of nanomaterials in dentistry.     

Dental considerations for head and neck cancer: A clinical review

IntroductionRadiotherapy is one of the treatment modalities for the treatment of head and neck cancer (HNC). However, it leads to the development of chronic and acute side effects. These side effects impact negatively on the patient’s quality of life and oral functioning. This clinical review aims to provide basic information about HNC, understand the impact of radiotherapy on oral health, and explain the role of dental care providers for HNC patients during the pre-and post-radiotherapy time.Materials and MethodsElectronic databases (i.e., PubMed, Scopus, and Google Scholar) were searched using defined keywords. The main inclusion criteria were any studies describing “dental management of patients with head and neck cancer” and “dental management of patients treated with radiotherapy.”ResultsThematic analysis was used to summaries the findings of the included studies (n = 102) into main headings and subheadings. All studies were published between 1970 and 2023.ConclusionThe number of HNC patients is increasing. This necessitates the need for raising the awareness of dental care providers to the side-effects of HNC therapy which includes treatment with radiotherapy, chemotherapy, and/or surgery. Dental care providers should understand the common side-effects and their treatments besides their role in the pre- (i.e., dental extraction of teeth with poor prognosis and maintaining good oral hygiene) and post- (i.e., oral rehabilitation and post-HNC dental care) radiotherapy dental care.     

Radiotherapy and the survival of dental implants: a systematic review

For patients with head and neck cancer, the effects of treatment with adjuvant radiotherapy can be devastating. Frequently there is loss of function due to tooth loss, pain and discomfort from xerostomia and mucositis, and a significant psychosocial impact. Dental implants provide an effective means of rehabilitation for many, but irradiation poses a unique set of challenges that can affect the outcome of treatment. The aims of this review were to find out whether radiotherapy in these patients affects the survival of dental implants, and to discuss details of pertinent influencing factors. An electronic search of the Medline, Web of Science, and CENTRAL databases was done to identify studies on the survival of implants in irradiated patients within specified inclusion and exclusion criteria. No restriction was placed on the year of publication. The primary outcome measure was implant survival. Seven studies involving 441 participants and 1502 implants placed into irradiated bone were included. Meta-analysis indicated that survival was significantly higher in the mandible compared with the maxilla (p = 0.04), and in non-irradiated cases compared with irradiated cases (p < 0.001). Other factors that showed a strong association with survival were radiation dose and timing of surgery. Implant-based rehabilitation is a viable option for head and neck cancer patients who have undergone radiotherapy. Whilst the short to medium-term implant survival in these cases is high, multiple factors require careful consideration for a favourable outcome. Further high-quality research and randomised controlled trials are required in this field.     

颌面部巨大血管畸形的放射治疗

目的 分析颌面部巨大血管畸形的临床特点及治疗方法,探讨放疗在血管畸形治疗中的可行性.方法 回顾分析2000年1月至2008年1月浙江大学医学院附属第二医院施行三维立体定向适形放射治疗的颌面部巨大血管畸形6例的临床资料,并主要根据影像检查与临床体检结果判断疗效.结果 6例患者在术中、术后无严重并发症,均对治疗后面部外形满意,MRI示病变范围缩小,甚至消失.随访0.5～9年,6例患者均无明显复发迹象.无一例出现视器损伤、张口受限等放疗并发症.结论 三维立体定向适形放疗可以作为一种安全有效治疗颌面部巨大血管畸形的方法.

Abstract：

Objective To discuss the clinical use of radiotherapy in the treatment of giant vascular malformation. Methods Six patients with giant vascular malformation in oral and maxillofacial region were treated by three dimensional radiation therapy in Department of Stomatology, The Second Affiliated Hospital,School of Medicne, Zhejiang University in the last ten years and the cilinical data were reviewed. The treatment results were evaluated by clinical examination and radiology. Results No complication was observed during and after the radiotherapy. All patients were satisfied with the aesthetic results. The lesions in MRI were all reduced and even disappeared. There was no sign of recurrence during the follow-up period.Conclusions Three dimensional radiotherapy is safe and effective for oral and maxillofical vascular malformation.     

头颈部放射治疗后拔牙与放射性颌骨骨髓炎关系的临床分析

目的探讨牙拔除术对头颈部放射治疗后患者发生放射性颌骨骨髓炎（osteoradionecrosis,ORN）的影响。方法收集83例头颈部恶性肿瘤放疗后经x线诊断ORN的需拔牙患者,拔牙前给予口服抗生素2d,微创拔牙,术后继续口服抗生素5d,3个月拔牙创不愈合者诊断为ORN。结果83例患者放疗后因智齿冠周炎、急性牙髓炎、残根残冠、根尖周炎等,共拔除182颗患牙,其中8例出现ORN。放疗剂量不同导致放疗后拔牙发生ORN的差异有统计学意义（x^2=5．004,P=0．025）,高剂量患者（70～80Gy）拔牙后ORN炎发生率25．00％,明显高于低剂量患者（50—70Gy）的发生率4．76％。放疗后拔牙时间（X2=0,P=I．000）、一次性拔牙总数目（x2=0,P=1．000）对放疗后拔牙发生ORN的差异无统计学意义。结论放射剂量是诱发ORN的主要原因,放疗前拔除患牙、放疗后定期检查口腔,防治牙周、牙体疾病是预防ORN的主要手段。