Publication
Efeitos adversos da radioterapia no tratamento de cancro da cabeça e pescoço: osteorradionecrose mandibular
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| PPG_29931 | 677.03 KB | Adobe PDF |
Advisor(s)
Abstract(s)
A Osteorradionecrose Mandibular constitui um dos efeitos adversos mais temíveis da radioterapia da cabeça e do pescoço. Devido a uma etiologia multifatorial e uma fisiopatologia complexa, ela ainda representa um grande desafio clínico e cirúrgico. Este tratamento resulta numa desvascularização óssea progressiva e irreversível dos tecidos irradiados. Os sintomas variam dependendo da severidade e extensão da destruição óssea levando, nos casos mais avançados, a uma fratura patológica da mandibula. Nesta revisão narrativa, descreveremos os mecanismos complexos da progressão patológica da osteorradionecrose e os vários sinais e sintomas clínicos que a caracterizam. As numerosas classificações atribuídas à osteorradionecrose, permitiram desenvolver um arsenal terapêutico médico-cirúrgico abastado, bem como a elaboração de cuidados pré, intra e pós a radioterapia, que iremos detalhar. Finalmente, sendo a prevenção o mecanismo de eleição no não desenvolvimento da osteorradionecrose, discutir-se-á como uma abordagem multidisciplinar individualizada, pré escolha terapêutica, levando a uma melhor a qualidade de vida dos pacientes.
Osteoradionecrosis of the jaw is one of the most dreadful radio-induced side effects of head and neck. With a multifactorial aetiology and a complex physiopathology, it still is a major clinical and surgical challenge. This treatment results in a progressive and irreversible bone devitalization of the irradiated bone. Symptoms vary dependending of the severity and extent of bone destruction, leading, in the most advanced cases, to a pathological mandibular fracture. In this review, we will describe the complex mechanisms of pathological progression of osteoradionecrosis and the various clinical signs and symptoms that characterize it. The numerous classifications attributed to the osteoradionecrosis enabled us to develop a well-equipped medical, surgical therapeutic arsenal and the elaboration of medical cares before, during and after radiotherapy, that we will detail. As prevention is the osteoradionecrosis election mechanism, we will see how the multidisciplinary approach, upstream of the therapeutic choice would improve patient quality of life.
Osteoradionecrosis of the jaw is one of the most dreadful radio-induced side effects of head and neck. With a multifactorial aetiology and a complex physiopathology, it still is a major clinical and surgical challenge. This treatment results in a progressive and irreversible bone devitalization of the irradiated bone. Symptoms vary dependending of the severity and extent of bone destruction, leading, in the most advanced cases, to a pathological mandibular fracture. In this review, we will describe the complex mechanisms of pathological progression of osteoradionecrosis and the various clinical signs and symptoms that characterize it. The numerous classifications attributed to the osteoradionecrosis enabled us to develop a well-equipped medical, surgical therapeutic arsenal and the elaboration of medical cares before, during and after radiotherapy, that we will detail. As prevention is the osteoradionecrosis election mechanism, we will see how the multidisciplinary approach, upstream of the therapeutic choice would improve patient quality of life.
Description
Keywords
Osteorradionecrose Radioterapia Cancro cabeça e pescoço Necrose mandibular Tratamento Qualidade de vida Osteoradionecrosis Radiation therapy Head and neck cancer Mandibular necrosis Treatment Quality of life