Int J Stomatol

Int J Stomatol ›› 2024, Vol. 51 ›› Issue (1): 28-35.doi: 10.7518/gjkq.2024018

• Oral Oncology • Previous Articles     Next Articles

Present application of digital oral positioning stents in radiotherapy of head and neck tumor

He Zimu1(),Li Fenglan1,2()   

  1. 1.School of Stomatology, Shanxi Medical University, Taiyuan 030000, China
    2.Dept. of Prosthodontics, Shanxi Provincial People’s Hospital, Taiyuan 030000, China
  • Received:2023-01-09 Revised:2023-08-29 Online:2024-01-01 Published:2024-01-10
  • Contact: Fenglan Li E-mail:1940533842@qq.com;uniquelfl@163.com
  • Supported by:
    Four “Batches” Innovation Project of Invigorating Medical Research through Science and Technology of Shanxi Province(2022XM41)

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Abstract:

In radiotherapy, normal tissues are inevitably damaged by radiation. Thus, patients suffering from head and neck tumor often develop serious oral complications, such as radiotherapy-induced oral mucositis, trismus, dysphagia, radiation osteonecrosis of the jaws, and radiation caries. These complications can affect or interrupt the delivery of radiation therapy. Accordingly, they have an immeasurable impact on the quality of patients’ lives after radiotherapy. To reduce the adverse effects of radiotherapy, domestic and foreign scholars have conducted extensive research on oral positioning stents (OPS). Conventional OPS plays a significant role in the prevention of those oral complications, but they have any disadvantages in design, fabrication, promotion, and application. Research on digital OPS has emerged. This work summarizes and analyzes the fabrication process, prevention of oral complications, and radiotherapy setup with digital OPS to improve the research direction and application prospects.

Key words: oral stents, head and neck cancer, radiation therapy, computer aided design, radiotherapy-induced oral mucositis, setup errors

CLC Number: 

  • R782

TrendMD: 

Tab 1

Influence of OPS on oral complications in HNT patients"

口腔并发症肿瘤临床分类放疗方式OPS主要发现参考文献
RIOM黏膜炎鼻咽癌IMRT传统型佩戴OPS者的口腔平均剂量降低至（32.98±1.91）Gy，将Ⅲ级黏膜炎并发症的发生率降至22.83%，比不佩戴者降低了2.52%；佩戴OPS者的腮腺平均剂量降低至（29.42±2.25）Gy，比不佩戴者的平均剂量降低了8.78%~15.39%[25]
鼻腔鼻窦癌、口腔癌、口咽癌3D-适形治疗和IMRT传统型佩戴OPS者Ⅲ级RIOM的发生时间推迟1周，Ⅲ级RIOM发病率比不佩戴者降低了19.4%[26]
舌癌IMRT数字化佩戴OPS者的上唇、上颊以及腭部的平均剂量分别减少了56%、53%、40%~72%[29]
味觉损害鼻咽癌常规放疗传统型佩戴OPS者味觉损害发生率为21.05%，较不佩戴者减少了58.12%[13]
口干症舌癌常规放疗传统型放疗开始30 d，佩戴OPS者较不佩戴者的口干不良事件评分降低40%[14]
舌癌常规放疗传统型

放疗后3个月，佩戴OPS者的未刺激唾液流率和刺激唾液流率分别为0.29 mL/min和0.64 mL/min，较不佩戴者分别增加38.1%、25.49%

放疗后6个月，佩戴OPS者的未刺激唾液流率和刺激唾液流率分别为0.13 mL/min和0.48 mL/min，较不佩戴者分别增加62.5%、29.73%

[28]
口咽癌IMRT传统型

单侧放疗佩戴OPS者和不佩戴OPS者MDASI-HN口干症的平均得分为3.08±2.91、3.38±3.19，不具有统计学意义（P=0.707）

双侧放疗佩戴OPS者和不佩戴OPS者MDASI-HN口干症的平均得分为4.20±2.97、4.04±2.99，不具有统计学意义（P=0.604）；佩戴者味觉损害发生率为2%，较不佩戴者减少了13%；佩戴者吞咽困难发生率为21%，较不佩戴者减少了10%

[27]
放射性颌骨坏死鼻咽癌IMRT数字化佩戴OPS者下颌骨接受的平均辐射剂量为（35.34±3.98）Gy，较不佩戴者减少了10.12%；佩戴OPS者舌接受的平均辐射剂量降为（35.96±4.98）Gy，较不佩戴者减少13.32%[17]
放射相关龋病口腔癌IMRT传统型佩戴OPS者上颌骨牙齿接受的平均剂量为（20.9±13.1）Gy，较不佩戴者减少了41.62%；佩戴OPS者腮腺接受的平均剂量降低至（35.0±9.7）Gy，较不佩戴者降低了16.27%[15]

"

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