RESUMO
BACKGROUND: Biochemical changes in irradiated malignant tissue lead to altered autofluorophores status which should be different for cancerous tissue (residual/recurrence) and irradiated normal tissue. If this irradiated tissue is examined through fluorescent spectroscopy, we can find the spectroscopic changes occurring after the completion of treatment which can be helpful in evaluating treatment response. METHODS: Punch biopsy sample was examined through fluorescent spectroscopy in oral cavity cancer patients before and after definitive radiation treatment. The change in spectroscopic pattern before and after radiation treatment was recorded and assessed. RESULTS: Final analysis was done in 36 samples. In irradiated tissue, it has been observed that there was increase in the intensity of collagen fluorescence. It was found that the Half width half maximum (HWHM) is more in case of preirradiated sample. The decrease in the HWHM in case of irradiated sample shows the decrease in the number of cells (cell density as compared to that in preirradiated sample). These spectral findings are well-explained pathophysiologically and clinically as amount of collagen are increased in irradiated tissues due to loss of cancerous cells and regeneration of collagen cross-links (fibrosis) and reproduction of normal tissue as a response to radiation treatment. CONCLUSION: After thorough study in a large number of samples, we may be able in the future to grade the alteration in fluorescence of collagen obtained after radiation treatment in terms of complete, partial, or no response.
Assuntos
Quimiorradioterapia/métodos , Mucosa Bucal/patologia , Neoplasias Bucais/terapia , Recidiva Local de Neoplasia/diagnóstico , Adulto , Feminino , Fibrose , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/efeitos da radiação , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/patologia , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/prevenção & controle , Estadiamento de Neoplasias , Neoplasia Residual , Espectrometria de Fluorescência , Resultado do TratamentoRESUMO
Background/aim: Quantification of oral mucositis that progresses during concomitant chemo-radiotherapy (CCRT) is essential for its management. It is important to determine the methods that are simple, reliable and beneficial in foreseeing mucositis at earlier stages of treatment. Materials and methods: A prospective study was conducted on 100 oral cancer patients receiving CCRT following the inclusion criteria. Patients were evaluated for mucositis i.e. erythema and ulcers by using the World Health Organization (WHO) scale and the oral mucositis assessment scale (OMAS), whereas mature and immature cells were identified by exfoliative cytology. Clinical examination and procedure of oral cavity were performed before, on days 5, 17, and at the end of treatment. Results: Oral mucositis was observed in all oral squamous cell carcinoma (OSCC) patients receiving CCRT on different days with noteworthy increase from day 5 of CCRT to the end of treatment. For OMAS grading related to ulceration and erythema, Grade 1 (7.2%; 34%) was most commonly seen on the 5th day of CCRT, Grade 2 (29%; 19%) and Grade 3 (19%) were most frequently seen at the 17th day and end of CCRT, accordingly. With respect to WHO scale grades 1 and 2 (18.3%; 21.5%) was most frequently observed at the 17th day of CCRT, whereas grades 3 and 4 (12.5%; 2%) was noted at the end of CCRT. There was statistically significant increase in the percentage of immature cells at the end of CCRT (99%). A significant association (P < 0.0000) was observed among the days of smear and maturation stages of epithelial cells as well as among WHO mucositis grading, OMAS and types of epithelial cells, respectively. Conclusion: According to the findings of the study, oral mucositis grade is directly proportional to the progressing days of CCRT. Oral mucositis is frequently related to adverse clinical outcomes, affecting the patient's quality of life. It is essential to develop methods that can be employed for the assessment of CCRT associated oral mucositis.
Assuntos
Antineoplásicos/efeitos adversos , Quimiorradioterapia/efeitos adversos , Neoplasias de Cabeça e Pescoço/terapia , Mucosa Bucal/efeitos dos fármacos , Mucosa Bucal/efeitos da radiação , Radioterapia/efeitos adversos , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Estomatite/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Eritema , Feminino , Neoplasias de Cabeça e Pescoço/epidemiologia , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Qualidade de Vida , Carcinoma de Células Escamosas de Cabeça e Pescoço/epidemiologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Estomatite/epidemiologia , Estomatite/terapiaRESUMO
INTRODUCTION: Biomarkers which can predict disease progression and serve as prognostic indicators are necessary for better management of oral cancer. Studies have shown that Cholinesterase plays an important role in cellular proliferation, differentiation and may have a possible involvement in tumor growth. AIM AND OBJECTIVE: The present study is aimed to determine the utility of serum Butyrylcholinesterase (BChe) levels as a marker for progression of oral squamous cell carcinoma (OSCC) in relation to the grade of the tumor and to determine if any variation occurred in the levels of BChe before and after therapy. MATERIALS AND METHODS: A total of 120 patients were included in the study and divided into two groups as Group A-30 patients (healthy individuals) and Group B-90 cases of histopathologically diagnosed OSCC. The blood sample was collected before surgery, re-collected after the completion of radiotherapy (i.e., 3 and 6 months postsurgery) and analyzed biochemically for the concentration of BCh. STATISTICAL ANALYSIS: Paired t-test, ANOVA, and post hoc test (Bonferroni) were used for determining the statistical significance. RESULTS: BChe levels were lower in OSCC (2940.32-1405.50 u/l when compared with controls (11149.60-11243.07 unit/l) and this difference was statistically significant. Postoperatively at 3 months, the serum BChe levels of OSCC patients increased almost two-fold compared to the preoperative values, and this difference was also statistically significant (P = 0.000) After 6 months, these levels further increased but did not reach those of controls. CONCLUSION: BChe can be used as an inexpensive, easy to use, noninvasive biomarker for the evaluation of disease-free survival in OSCC patients.
Assuntos
Biomarcadores Tumorais/sangue , Butirilcolinesterase/sangue , Neoplasias Bucais/diagnóstico , Recidiva Local de Neoplasia/epidemiologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico , Adulto , Biomarcadores Tumorais/economia , Butirilcolinesterase/economia , Estudos de Casos e Controles , Intervalo Livre de Doença , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/patologia , Mucosa Bucal/efeitos da radiação , Mucosa Bucal/cirurgia , Neoplasias Bucais/sangue , Neoplasias Bucais/mortalidade , Neoplasias Bucais/terapia , Período Pós-Operatório , Período Pré-Operatório , Prognóstico , Radioterapia Adjuvante , Carcinoma de Células Escamosas de Cabeça e Pescoço/sangue , Carcinoma de Células Escamosas de Cabeça e Pescoço/mortalidade , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapiaRESUMO
BACKGROUND: Cancer therapy couples with it a plethora of complications of short and long term effects which can be so distressing that patient may tolerate only lower less-effective doses of therapy, may postpone treatments or will discontinue treatment entirely. Fractionated dose of radiotherapy coupled with therapy induce local or systemic infections due to high cellular turnover rates of the oral mucosa, diverse and complex microflora and trauma to oral tissues. Several mucosal abnormalities often results in epithelial and glandular destruction and inflammation, which can be so devastating that it may cause atypical changes on the area exposed to radiation. Thus, the aim of this study was to investigate the feasibility of using cytological evaluation to detect oral epithelial atypia among Head and Neck cancer patients receiving fractionated dose of radiotherapy. METHODS: Study was conducted on 125 head and neck cancer patients receiving radiotherapy. Subjects were divided into 5 study groups on the basis of fractionated dose of radiotherapy from 10th-50th fractions respectively. Mucosal changes were evaluated by exfoliative cytology and atypical changes and inflammatory cell infiltration were assessed. RESULTS: Without prior knowledge of the subjects' group, oral epithelial atypia was detected with increase fractionated dose of radiation. Dense inflammatory nfiltrate were identified in nearly all study groups irrespective of dose of radiotherapy. CONCLUSION: Cytological atypia and inflammatory infiltrates were detected after exposure to radiotherapy.
Assuntos
Neoplasias de Cabeça e Pescoço/radioterapia , Mucosa Bucal/efeitos da radiação , Citodiagnóstico/métodos , Fracionamento da Dose de Radiação , Humanos , Mucosa Bucal/patologiaRESUMO
BACKGROUND AND PURPOSE: Current oral mucositis normal tissue complication probability models, based on the dose distribution to the oral cavity volume, have suboptimal predictive power. Improving the delineation of the oral mucosa is likely to improve these models, but is resource intensive. We developed and evaluated fully-automated atlas-based segmentation (ABS) of a novel delineation technique for the oral mucosal surfaces. MATERIAL AND METHODS: An atlas of mucosal surface contours (MSC) consisting of 46 patients was developed. It was applied to an independent test cohort of 10 patients for whom manual segmentation of MSC structures, by three different clinicians, and conventional outlining of oral cavity contours (OCC), by an additional clinician, were also performed. Geometric comparisons were made using the dice similarity coefficient (DSC), validation index (VI) and Hausdorff distance (HD). Dosimetric comparisons were carried out using dose-volume histograms. RESULTS: The median difference, in the DSC and HD, between automated-manual comparisons and manual-manual comparisons were small and non-significant (-0.024; p=0.33 and -0.5; p=0.88, respectively). The median VI was 0.086. The maximum normalised volume difference between automated and manual MSC structures across all of the dose levels, averaged over the test cohort, was 8%. This difference reached approximately 28% when comparing automated MSC and OCC structures. CONCLUSIONS: Fully-automated ABS of MSC is suitable for use in radiotherapy dose-response modelling.
Assuntos
Neoplasias de Cabeça e Pescoço/radioterapia , Mucosa Bucal/efeitos da radiação , Órgãos em Risco , Atlas como Assunto , Relação Dose-Resposta à Radiação , Humanos , Radiometria/métodos , Dosagem RadioterapêuticaRESUMO
It is known that high-dose radiation has an effect on tissue healing, but tissue healing does not occur when low dose radiation is applied. To clarify this issue, we compare the treatment success of low dose radiation with programmed cell death mechanisms on wounded tissue. In this study, we aimed to investigate the interactions of low and high-dose radiation using an autophagic mechanism. We included 35 adult Wistar-Albino rats in this study. All animals were injected with 100 mg/kg of 5-fluorouracil (5-FU) on the first day and 65 mg/kg of 5-FU on the third day. The tips of 18-gauge needles were used to develop a superficial scratching on the left cheek pouch mucosa by dragging in a linear movement on third and fifth days. After mucositis formation was clinically detected, animals were divided into five groups (n = 7). Different wavelengths of laser irradiations (1064 nm, Fidelis Plus, Fotona, Slovenia; 980 nm, FOX laser, A.R.C., Germany; 810 nm, Fotona XD, Fotona, Slovenia; 660 nm, HELBO, Medizintechnik GmbH, Wels, Austria) were performed on four groups once daily for 4 days. The laser irradiation was not performed on the control group. To get the tissue from the left cheek at the end of fourth day from all animals, oval excisional biopsy was performed. Molecular analysis assessments of pathological and normal tissue taken were performed. For this purpose, the expression analysis of autophagy genes was performed. The results were evaluated by normalization and statistics analysis. We found that Ulk1, Beclin1, and Atg5 expression levels were increased in the rats when the Nd:YAG laser was applied. This increase showed that a 1064-nm laser is needed to activate the autophagic mechanism. However, in the diode applications, we found that Beclin1, Atg10, Atg5, and Atg7 expressions numerically decreased. Atg5 is responsible for the elongation of autophagosome. Becn1 is a control gene in the control mechanism of autophagy. The reduction of the expression of these genes leads us to think that it may depend on the effect of drug (5-FU) used to form model. Expressions of therapeutic genes increase to ensure hemostasis, but in our study, expressions were found to decrease. More detailed studies are needed.
Assuntos
Autofagia/efeitos da radiação , Lasers Semicondutores/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade , Mucosite/radioterapia , Animais , Masculino , Mucosa Bucal/efeitos da radiação , Ratos , Ratos Wistar , Resultado do TratamentoRESUMO
OBJECTIVES: When bitewing radiographs are not possible (e.g. patients with special needs), oblique lateral radiographs may offer an alternative. The aims of this study were to assess the impact of horizontal projection angulation, focus-to-skin distance, exposure time and age of the patient on the equivalent radiation dose of several organs in the head and neck region by means of personal computer X-ray Monte Carlo (PCXMC) calculations and to assess the dose obtained from conventional bitewing radiographs. METHODS: PCXMC v. 2.0 software (STUK(®), Helsinki, Finland) was used to estimate the equivalent radiation doses and the total effective dose. Three exposure times, five age categories, two focus-to-skin distances and eight horizontal geometric angulations were assumed. The organs involved were the thyroid gland, oesophagus, salivary glands, bone marrow, oral mucosa, skull, cervical spine and skin. A similar calculation was also performed for bitewings taken with a rectangular collimator. Results and conclusion Bitewings taken with rectangular collimation decrease the radiation burden of the patient to 50%, compared with circular collimation. In the oblique lateral radiographs, focus-to-skin distance, patient's age and beam collimation had a significant impact on the equivalent doses measured in this study. Exposure time had a significant impact on the equivalent doses of the salivary glands, oral mucosa, skull and skin. Horizontal angulations had a significant impact on the equivalent doses of the thyroid gland, bone marrow, oral mucosa, skull and cervical spine. The total effective radiation dose was significantly influenced by all parameters investigated in this study.
Assuntos
Cabeça/efeitos da radiação , Pescoço/efeitos da radiação , Doses de Radiação , Radiografia Interproximal/estatística & dados numéricos , Radiografia Dentária/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Medula Óssea/efeitos da radiação , Vértebras Cervicais/efeitos da radiação , Criança , Pré-Escolar , Esôfago/efeitos da radiação , Humanos , Lactente , Método de Monte Carlo , Mucosa Bucal/efeitos da radiação , Radiografia Interproximal/métodos , Radiografia Dentária/métodos , Glândulas Salivares/efeitos da radiação , Pele/efeitos da radiação , Crânio/efeitos da radiação , Software , Glândula Tireoide/efeitos da radiação , Fatores de TempoRESUMO
Transmission and reception of mobile telephony signals take place through electromagnetic wave radiation, or electromagnetic radiofrequency fields, between the mobile terminal and the radio base station. Based on reports in the literature on adverse effects from exposure to this type of radiation, the objective of this study was to evaluate the genotoxic and cytotoxic potential of such exposure, by means of the micronucleus test on exfoliated cells from the oral epithelium. The sample included 45 individuals distributed in 3 groups according to the amount of time in hours per week (t) spent using mobile phones: group I, t > 5 h; group II, t > 1 h and ≤ 5 h; and group III, t ≤ 1 h. Cells from the oral mucosa were analyzed to assess the numbers of micronuclei, broken egg structures and degenerative nuclear abnormalities indicative of apoptosis (condensed chromatin, karyorrhexis and pyknosis) or necrosis (karyolysis in addition to these changes). The occurrences of micronuclei and degenerative nuclear abnormalities did not differ between the groups, but the number of broken egg (structures that may be associated with gene amplification) was significantly greater in the individuals in group I (p < 0.05).
Assuntos
Núcleo Celular/efeitos da radiação , Telefone Celular , Mucosa Bucal/citologia , Ondas de Rádio/efeitos adversos , Adulto , Núcleo Celular/genética , Dano ao DNA , Humanos , Testes para Micronúcleos , Mucosa Bucal/efeitos da radiação , Fatores de TempoRESUMO
Oral mucositis (OM) is a painful and debilitating complication of cancer therapy that can adversely affect patients' treatment regimens and quality of life. It is also considered to be a substantial burden on the financial and human resources of health services. Despite progress in the understanding of the pathophysiology of OM and the number of new treatments that have been developed, there remains an unmet need for effective preventative measures in clinical practice. Literature on oral healthcare management in oncology patients suggests that a preventative approach consisting of a supersaturated Ca2+ / PO4(3-) oral rinse (Caphosol(®)) aimed at maintaining oral hygiene, moistening and lubricating the oral cavity, effectively reduces the incidence and severity of OM. This review looked at data from all known adult and paediatric studies investigating the use of Caphosol(®) in patients receiving high-dose cancer therapy in order to evaluate its efficacy for both the prevention and treatment of OM. Thirty studies were identified. The majority of these studies (n = 24) found Caphosol(®) to be efficacious at reducing the grade and/or duration, as well as pain associated with OM. Despite important limitations, these data warrant serious consideration for the inclusion of Caphosol(®) in regimens for preventing or reducing the debilitating effects of OM.
Assuntos
Antineoplásicos/efeitos adversos , Fosfatos de Cálcio/administração & dosagem , Mucosa Bucal/efeitos da radiação , Antissépticos Bucais/administração & dosagem , Lesões por Radiação/prevenção & controle , Estomatite/prevenção & controle , Administração Oral , Antineoplásicos/economia , Fosfatos de Cálcio/economia , Redução de Custos , Nutrição Enteral/estatística & dados numéricos , Métodos Epidemiológicos , Humanos , Tempo de Internação , Antissépticos Bucais/economia , Neoplasias/tratamento farmacológico , Neoplasias/radioterapia , Dor/prevenção & controle , Satisfação do Paciente , Radioterapia/efeitos adversos , Estomatite/economia , Estomatite/etiologia , Resultado do TratamentoRESUMO
Photodynamic therapy (PDT) is based on the synergism of a photosensitive drug (a photosensitizer) and visible light to destroy target cells (e.g., malignant, premalignant, or bacterial cells). The aim of this study was to investigate the response of normal rat tongue mucosa to PDT following the topical application of hematoporphyrin derivative (Photogem®), Photodithazine®, methylene blue (MB), and poly(lactic-co-glycolic acid) (PLGA) nanoparticles loaded with MB. One hundred and thirty three rats were randomly divided in various groups: the PDT groups were treated with the photosensitizers for 10 min followed by exposure to red light. Those in control groups received neither photosensitizer nor light, and they were subjected to light exposure alone or to photosensitizer alone. Fluorescent signals were obtained from tongue tissue immediately after the topical application of photosensitizers and 24 h following PDT. Histological changes were evaluated at baseline and at 1, 3, 7, and 15 days post-PDT treatment. Fluorescence was detected immediately after the application of the photosensitizers, but not 24 h following PDT. Histology revealed intact mucosa in all experimental groups at all evaluation time points. The results suggest that there is a therapeutic window where PDT with Photogem®, Photodithazine®, MB, and MB-loaded PLGA nanoparticles could safely target oral pathogenic bacteria without damaging normal oral tissue.
Assuntos
Mucosa Bucal/efeitos dos fármacos , Fotoquimioterapia/efeitos adversos , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/administração & dosagem , Administração Oral , Animais , Fluorescência , Glucosamina/administração & dosagem , Glucosamina/análogos & derivados , Glucosamina/farmacologia , Derivado da Hematoporfirina/administração & dosagem , Derivado da Hematoporfirina/farmacologia , Ácido Láctico/administração & dosagem , Ácido Láctico/farmacologia , Masculino , Azul de Metileno/administração & dosagem , Azul de Metileno/uso terapêutico , Mucosa Bucal/citologia , Mucosa Bucal/efeitos da radiação , Nanopartículas/administração & dosagem , Fármacos Fotossensibilizantes/uso terapêutico , Ácido Poliglicólico/administração & dosagem , Ácido Poliglicólico/farmacologia , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Ratos , Ratos WistarRESUMO
OBJECTIVE: The aim of this study was to assess the incidence of micronuclei (MN) in buccal mucosal cells of professionals working in radiology area to determine the risk of stochastic effects of radiation. MATERIALS AND METHODS: All the professionals and students working in King Khalid University - College of Dentistry radiology area were included in the Risk Group (RG = 27). The Control Group (CG = 27) comprised of healthy individual matching the gender and age of the RG. Buccal mucosal scraping from all the 54 subjects of RG and CG were stained with Papanicolaou stain and observed under oil immersion lens (×100) for the presence of micronuclei (MN) in the exfoliated epithelial cells. RESULTS: There was no significant difference between the incidence of MN in RG and CG (p = >0.05) using t-test. CONCLUSION: Routine radiation protection protocol does minimize the risk of radiation induced cytotoxicity, however, screening of professionals should be carried out at regular intervals.
Assuntos
Odontólogos , Mucosa Bucal/efeitos da radiação , Exposição Ocupacional , Radiologia , Faculdades de Odontologia , Estudantes de Odontologia , Adulto , Estudos de Casos e Controles , Núcleo Celular/patologia , Núcleo Celular/efeitos da radiação , Citoplasma/patologia , Citoplasma/efeitos da radiação , Células Epiteliais/patologia , Células Epiteliais/efeitos da radiação , Feminino , Humanos , Masculino , Testes para Micronúcleos , Mucosa Bucal/patologia , Teste de Papanicolaou , Proteção Radiológica/métodos , Medição de Risco , Adulto JovemRESUMO
OBJECTIVES: The aims of this study were to assess the organ and effective dose (International Commission on Radiological Protection (ICRP) 103) resulting from dental cone-beam computerized tomography (CBCT) imaging using a novel metal-oxide semiconductor field-effect transistor (MOSFET) dosimeter device, and to assess the reliability of the MOSFET measurements by comparing the results with Monte Carlo PCXMC simulations. STUDY DESIGN: Organ dose measurements were performed using 20 MOSFET dosimeters that were embedded in the 8 most radiosensitive organs in the maxillofacial and neck area. The dose-area product (DAP) values attained from CBCT scans were used for PCXMC simulations. The acquired MOSFET doses were then compared with the Monte Carlo simulations. RESULTS: The effective dose measurements using MOSFET dosimeters yielded, using 0.5-cm steps, a value of 153 µSv and the PCXMC simulations resulted in a value of 136 µSv. CONCLUSIONS: The MOSFET dosimeters placed in a head phantom gave results similar to Monte Carlo simulations. Minor vertical changes in the positioning of the phantom had a substantial affect on the overall effective dose. Therefore, the MOSFET dosimeters constitute a feasible method for dose assessment of CBCT units in the maxillofacial region.
Assuntos
Tomografia Computadorizada de Feixe Cônico/instrumentação , Cabeça/efeitos da radiação , Doses de Radiação , Radiografia Dentária/instrumentação , Radiometria/instrumentação , Transistores Eletrônicos , Medula Óssea/efeitos da radiação , Encéfalo/efeitos da radiação , Simulação por Computador , Esôfago/efeitos da radiação , Olho/efeitos da radiação , Ossos Faciais/efeitos da radiação , Humanos , Linfonodos/efeitos da radiação , Masculino , Modelos Estatísticos , Método de Monte Carlo , Mucosa Bucal/efeitos da radiação , Imagens de Fantasmas , Eficiência Biológica Relativa , Glândulas Salivares/efeitos da radiação , Pele/efeitos da radiação , Crânio/efeitos da radiação , Glândula Tireoide/efeitos da radiaçãoRESUMO
OBJECTIVES: The aim of the present study was to evaluate DNA damage (micronucleus) and cellular death (pyknosis, karyolysis and karyorrhexis) in exfoliated buccal mucosa cells from individuals following radiography. METHODS: Lateral and frontal cephalometric X-ray and panoramic dental X-rays were taken of a total of 18 healthy patients (6 male and 12 female) referred for orthodontic therapy. Exfoliated oral mucosa cells were collected immediately before X-ray exposure and after 10 days. RESULTS: The results revealed no statistically significant difference (P > 0.05) in the frequency micronucleated oral mucosa cells after X-ray exposure. However, X-ray was able to increase other nuclear alterations closely related to cytotoxicity, such as karyorrhexis, pyknosis and karyolysis. CONCLUSIONS: Data indicated that exposure to certain radiography may not be a factor in inducing chromosomal damage, but it does promote cytotoxicity.
Assuntos
Cefalometria/efeitos adversos , Dano ao DNA , Mucosa Bucal/efeitos da radiação , Ortodontia , Radiografia Panorâmica/efeitos adversos , Adolescente , Cromossomos/efeitos da radiação , Células Epiteliais/efeitos da radiação , Feminino , Humanos , Masculino , Testes para Micronúcleos , Mucosa Bucal/citologiaRESUMO
Using a CO(2) laser beam for biopsy is compromised by thermal cytological artefacts that could be critical when assessing dysplastic changes, as they may simulate cytological atypia. This study examined wounds caused by CO(2) laser, evaluating their size and features, utilizing 25 Sprage rats randomly allocated to five groups: four glossectomized using a CO(2) laser at 3, 6, 9 and 12 W and a control group treated with a conventional scalpel. Samples were prepared in 4 microm sections, stained, and studied double-blind by two pathologists. The artefacts identified included cellular and nuclear polymorphism, nuclear hyperchromatism and loss of intercellular adherence; they were mainly located in the basal and suprabasal layers of the oral epithelium. Number of artefacts per specimen did not differ between experimental groups. The width of epithelial damage adjacent to the laser incisions revealed 298.7+/-150.7 microm of damaged tissue (range 100-750 microm), with no differences between low (3 W) and high wattages (6, 9 and 12 W) (X(i)-X(j)=41.6; 95% CI=-125.1 to 208.4). No changes were observed in the control group. CO(2) laser (3-12 W) generates epithelial damage that can simulate light dysplasia with atypias mainly affecting basal and suprabasal layers that may lead to erroneous therapy.
Assuntos
Artefatos , Biópsia/instrumentação , Glossectomia/instrumentação , Lasers de Gás/efeitos adversos , Terapia com Luz de Baixa Intensidade/efeitos adversos , Neoplasias Bucais/diagnóstico , Animais , Biópsia/métodos , Mucosa Bucal/efeitos da radiação , Distribuição Aleatória , Ratos , Ratos Sprague-DawleyRESUMO
Radiotherapy to the head and neck region leads to severe side effects in the oral cavity but knowledge about severity and onset is scarce among oncology nurses in a radiotherapy department. The aim was to test the Oral Assessment Guide for reliability and validity for patients receiving radiotherapy to the head and neck region. A prospective design with repeated assessments was selected. Thirty-six outpatients admitted to the department for radiotherapy to the head and neck region were included. In connection with the treatment session, the oral cavity was examined every second day by a nurse and once a week by an oncologist. The results were documented on separate forms. All patients showed alterations in the oral cavity and side effects started early during the first week of treatment. The result from inter-rater reliability showed a high concordance in all categories (>71%). Cohen's kappa (k) showed good agreement for voice, swallow and saliva and moderate for lips, tongue, mucous membranes, gums and teeth/dentures. The association, the sensitivity, between dose of radiation and side effects was weak or moderate and the acceptability with patients and staff was generally good.
Assuntos
Neoplasias de Cabeça e Pescoço/radioterapia , Boca/efeitos da radiação , Atividades Cotidianas , Adulto , Idoso , Idoso de 80 Anos ou mais , Relação Dose-Resposta à Radiação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/patologia , Mucosa Bucal/efeitos da radiação , Projetos Piloto , Estudos Prospectivos , Lesões por Radiação/patologia , Dosagem Radioterapêutica , Reprodutibilidade dos TestesRESUMO
OBJECTIVE: To evaluate the role of WF10-immunotherapy in reducing oro-pharyngeal complications in head and neck cancer chemoradiotherapy. MATERIAL AND METHOD: Thirteen patients were enrolled and assigned either to WF10- (n = 6) or control group (n = 7). After completion of their initial (neoadjuvant) chemotherapy, patients received WF10 intravenous infusions at 0.5 mL/kg body weight/day for five consecutive days and repeated every 3 weeks, concomitantly to standard radiotherapy (6,600-7,500 cGy, 200 cGy/day). Control patients received radiotherapy alone. RESULTS: Patients in the WF10-group had a lower incidence of oro-pharyngeal complications grade > 2, including oral mucositis (1 vs. 5), dysphagia (2 vs. 7), oral pain (3 vs. 5), taste alteration (4 vs. 6) and weight loss (2 vs. 4). The statistical significances were achieved for the parameters of oral mucositis (p = 0. 048) and dysphagia (p = 0.009). CONCLUSION: WF10 appears to reduce severity of oro-pharyngeal complications associated with standard chemoradiotherapy for head and neck cancer.
Assuntos
Cloro/administração & dosagem , Mucosa Bucal/efeitos da radiação , Mucosite/prevenção & controle , Neoplasias Nasofaríngeas/radioterapia , Óxidos/administração & dosagem , Lesões por Radiação/prevenção & controle , Protetores contra Radiação/administração & dosagem , Adulto , Esquema de Medicação , Feminino , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Mucosite/etiologiaRESUMO
Using the method of laser correlation spectroscopy of biological fluids (blood serum, urine, oropharyngeal washout fluid) we studied the types of metabolic shifts in workers employed in nuclear fuel complex plant. In was found that the incidence of catabolic shifts considerably increased in workers with higher level of occupational exposure. In individuals contacting with open radiation sources we found the contribution of anabolic immunomodifying shifts with predominance of autoimmune sensibilization. A risk group for blood diseases was identified.
Assuntos
Metabolismo/efeitos da radiação , Reatores Nucleares , Saúde Ocupacional , Adulto , Anemia/diagnóstico , Sangue/efeitos da radiação , Análise Química do Sangue , Humanos , Lasers , Mucosa Bucal/efeitos da radiação , Exposição Ocupacional , Análise Espectral/métodos , Urina/químicaRESUMO
PURPOSE: The oral complications associated with radiotherapy to the head and neck are a significant dose-limiting factor. The goals of this study were to determine whether oropharyngeal rinsing and ingestion of misoprostol protect mucous membranes from the acute effects of irradiation, and to evaluate the quality-of-life (QOL) outcomes of patients receiving misoprostol. We report the results of the QOL outcomes of patients in this study. METHODS AND MATERIALS: A total of 33 patients with resected or intact cancer of the oral cavity, oropharynx, supraglottic larynx, or hypopharynx were registered to receive postoperative radiotherapy plus misoprostol or primary radiotherapy plus misoprostol. All patients were scheduled to receive 60-70 Gy at 2 Gy/d within 6-7 weeks. QOL and function were evaluated. RESULTS: A decrease in the QOL and function occurred in all areas covered by the questionnaire at the 6-week interval. This decrease was significant for eating, saliva, taste, and mucous. Of these significant factors, taste, saliva, and mucous consistency had not resolved by 12 weeks. CONCLUSION: Increased understanding of the impact of treatment on QOL and symptoms will formulate the rational design of toxicity interventions and enhance the multidisciplinary care of head-and-neck patients.
Assuntos
Alprostadil/análogos & derivados , Misoprostol/uso terapêutico , Mucosa Bucal/efeitos da radiação , Neoplasias Bucais/prevenção & controle , Mucosa/efeitos da radiação , Faringe/efeitos da radiação , Adulto , Idoso , Antineoplásicos/uso terapêutico , Feminino , Humanos , Neoplasias Laríngeas/radioterapia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/radioterapia , Metástase Neoplásica/prevenção & controle , Neoplasias Faríngeas/radioterapia , Qualidade de Vida , Inquéritos e Questionários , Fatores de TempoRESUMO
STATEMENT OF PROBLEM: For some patients, radiation treatment is a part of tumor therapy in the head and neck area before and/or after surgery. The oral cavity and teeth are thereby frequently exposed to high doses of radiation. In this situation, electronic backscatter from dental materials may damage the surrounding soft tissue. PURPOSE: This study determined the degree of absorption and the backscatter effect of therapeutic radiation used in the presence of 4 different dental materials. The efficacy of a protective stent also was investigated. MATERIAL AND METHODS: The influence of 4 dental materials (a high-gold alloy, pure titanium, amalgam, and a synthetic material) on radiation dose distribution was tested on 2 test models that simulated the presence of teeth. An alanine dosimeter was used to make measurements with and without the presence of a protective stent. To verify the results, one of the test models was compared to a computer simulation. RESULTS: Backscatter effects on the surface of dental materials caused an increase of up to 170% of the radiation dose measured without the materials. The rate of overdose increased with the atomic number of the dental material. The extent of the backscatter effect was a maximum of 4 mm. CONCLUSION: The considerable overdose of 170% found in this study suggests that soft tissue surrounding dental restorations should be protected from radiation. The backscatter results indicate that soft tissue could be effectively shielded with a 3-mm synthetic stent.
Assuntos
Materiais Dentários/efeitos da radiação , Restauração Dentária Permanente , Radioterapia , Absorção , Resinas Acrílicas/efeitos da radiação , Alanina , Resinas Compostas/efeitos da radiação , Simulação por Computador , Amálgama Dentário/efeitos da radiação , Elétrons , Ligas de Ouro/efeitos da radiação , Humanos , Modelos Biológicos , Método de Monte Carlo , Mucosa Bucal/efeitos da radiação , Imagens de Fantasmas , Doses de Radiação , Proteção Radiológica/instrumentação , Radiometria/instrumentação , Dosagem Radioterapêutica , Espalhamento de Radiação , Stents , Titânio/efeitos da radiaçãoRESUMO
We analyzed case histories of 495 patients with oral cancer treated in the Head and Neck Tumor Clinic of the Russian Cancer Research Center RAMS from 1985 to 1998. 88 patients were included in the study out of which 50 reserved combined (radiotherapy + surgery) and 38--complex (chemotherapy + radiotherapy + surgery) treatment. On assessing the clinical results we got the following results: after combined treatment 5-year survival was 45.9 +/- 7.0%, while after the complex method--37.2 +/- 7.8%. The inclusion of chemotherapy to the treatment does not significantly influence long-term results.