소아환자의 항암치료 후 나타나는 구강 내 합병증
Oral Complications after Antineoplastic Treatment in Pediatric Patients
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초록
이 연구의 목적은 항암 치료를 받은 후 소아환자에서 나타나는 치아의 발육장애의 유병률에 대해 조사하고, 항암 치료의 시기, 치료방법, 그리고 치료 기간에 따라 어떤 차이를 보이는 지 알아보고자 하였다. 임상 및 방사선학적 기록이 존재하는 93명의 소아암 환자에 대해 치아의 수, 치아의 형태, 치근의 형태, 치아의 발달 정도를 평가하였다. 조사된 치아의 형성장애는 전체 환자의 61.3%에서 발견되었고, 이중에는 치근의 형태이상이 31.2%로 가장 많이 관찰되었다. 6세 이후에 항암치료를 시작한 환아보다 6세 이전에 항암 치료를 시작한 환아에서 결손치(p = 0.029)와 왜소치(p = 0.003) 수가 더 많았으며, 이는 통계적으로 유의한 차이를 나타냈다. 화학요법과 방사선요법을 병행한 경우 화학요법만을 시행한 경우보다 결손치(p = 0.030), 왜소치(p = 0.046), 그리고 치근형태이상(p = 0.009)이 더 높은 빈도로 관찰되었고, 이는 통계적으로 유의한 차이를 나타냈다. 18개월미만의 항암 치료 기간을 경험한 환아에 비해 18개월 이상 항암 치료를 받은 환아에서 결손치(p = 0.032), 왜소치(p = 0.011), 치근형태이상(p = 0.025), 그리고 총 치아이상(p = 0.036)의 수가 더 많았으며, 이는 통계적으로 유의한 차이를 나타냈다. 결론적으로, 항암치료를 받은 소아환자에서 더 빠른 항암치료 개시시기, 화학 및 방사선 요법의 병행, 그리고 더 긴 항암치료 기간이치아 형성 중의 이상소견을 증가시켰다.
Abstract
The purpose of this study was to examine dental complications and to evaluate the effects of initial treatment age, treatment modalities, and treatment duration on the disorder after radiation and chemotherapy in pediatric cancer patients. For 93 children with clinical and radiographic data, the number of teeth, the morphology of teeth, the shape of the roots, and development status of the dentition were evaluated. Dental development disorders were found in 61.3% of the children. The mostly found abnormality was root deformity with the prevalence of 31.2%. In children submitted to the therapy before the age of 6, the number of missing teeth (p = 0.029) and microdontia (p = 0.003) were greater compared to the children who started to receive the treatment after the age of 6. The combination of radiation and chemotherapy showed significantly greater incidences of missing teeth (p = 0.030), microdontia (p = 0.046), and root deformity (p = 0.009) when compared with the sole application of chemotherapy. When the children were submitted to anticancer therapy for 18 months or longer duration, greater number of missing teeth (p = 0.032), microdontia (p = 0.011), root deformity (p = 0.025), and total number of teeth affected (p = 0.036) were observed compared with duration less than 18 months. The number of dental abnormalities increased when the children were treated at earlier ages, with combination of radiation and chemotherapy, and for longer period of time.
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