Alterações Orais Tardias em Pacientes Submetidos a Radioterapia e/ou Quimioterapia em Cabeça e Pescoço

• Ano de defesa: 2011
• Autor(a) principal: Deboni, Aline Lima da Silva [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Complicações Orais; Efeitos Tardios; Quimioterapia; Radioterapia; Câncer de cabeça e pescoço; Oral complications; Delayed effects; Chemotherapy; Radiotherapy; Head and neck neoplasms
• Link de acesso: http://repositorio.unifesp.br/handle/11600/8888

Purpose: To assess the late oral complications (LOC) in non surgical head and neck cancer (HNC) patients, submitted to radiotherapy (RT) with or without chemotherapy (chemo). Materials and Methods: The average follow-up for HNC patients was 17.1 months. Five hundred fifteen charts from patients treated for HNC between 2005 and 2009 were reviewed and 41 non surgical HNC patients met the inclusion criteria. Salivary glands function was assessed using a simplified new grading system (NGSX) (Esibruch et al. 2003) and sialometry. Late effects were assessed using the Common Toxicity Criteria (CTC) - Radiotherapy and Oncology Group /European Organization for Research and Treatment of Cancer (RTOG/EORTC) - Late Radiation Morbidity Scale. Data were submitted to statistical analysis. Results: There was a predominance of mild LOC complications among the variables studied. A statistical correlation was found for both unstimulated/stimulated salivary flow rates and the average CTC – RTOG/EORTC grades for the mucous membrane. The low salivary flow rates (<0.03 mL/min e <0.09 mL/min) were identified as a potential risk factor (p <0.005) and an independent predictor for mucous membrane toxicity (for ≥2 grades). A significant correlation was also found between objective NGSX scores (p = 0.001) and CTC – RTOG/EORTC grades for salivary glands. Eighty five percent of the patients were classified as suffered from hyposalivation as well as 58,7% considered the dryness in the mouth the most debilitating complication. Conclusions: Considering the late effects assessed, the majority of patients presented mild graduation (0 and 1) according to CTC – RTOG/EORTC criteria; the demographic, tumor and treatment variables were not statistically significant for the development and severity of late oral complication; the salivary hipofunction increased from 4.3 to 8.3 times the RR for the occurrence of severe late mucosal reaction; xerostomia was considered the most debilitating complication after treatment. Data show the role of salivary hypofunction as an independet predictor for the severity of late mucous membrane complication.