RESUMO
Introdução: a radioterapia é uma das principais modalidades de tratamento das neoplasias malignas de cabeça e pescoço. Entretanto sua ação não se restringe às células cancerígenas, produzindo efeitos colaterais comumente reportadas pelos pacientes. Objetivo: avaliar a ocorrência de comorbidades de interesse para o Cirurgião-dentista, relacionadas ao tratamento oncológico em pacientes submetidos a radioterapia de cabeça e pescoço (RCP) associada ou não a quimioterapia em um serviço de referência do Sistema Único de Saúde na cidade de Salvador-BA. Metodologia: foram incluídos 35 indivíduos submetidos a RCP associado ou não a quimioterapia. Foi realizada consulta odontológica a cada 48 horas, a fim de identificar queixas de disgeusia, disfagia e xerostomia e a instalação de lesões orais, como candidíase e mucosite oral. Resultados: 82,9% da amostra foi composta de indivíduos do gênero masculino e 17,1% do feminino, com idade média de 58,2 anos. Com relação às comorbidades relativas ao tratamento radioterápico em região de cabeça e pescoço, pode-se observar alta prevalência de mucosite oral (74,28%), disfagia (60%), candidíase (40%) e, em menor número, disgeusia (22,85%) e xerostomia (14,28%). Conclusão: a RCP, embora se apresente como uma eficiente modalidade terapêutica para neoplasias malignas, usualmente se associa a uma série de complicações na região irradiada. Na amostra estudada, a mucosite oral foi a comorbidade mais frequente, seguida de disfagia e candidíase.
Introduction: radiation therapy is one of the main treatment modalities for malignant head and neck neoplasms. However its action is not restricted to cancer cells, producing side effects commonly reported by these patients. Objective: evaluating the occurrence of comorbidities of interest to the dentist related to cancer treatment in patients undergoing head and neck radiotherapy (CPR) associated or not with chemotherapy in a reference service of the Unified Health System in Salvador-BA. Metodology: 35 individuals submitted CPR with or without chemotherapy were included. Dental appointments were performed every 48 hours to identify complaints of dysgeusia, dysphagia and xerostomia and oral lesions development such as candidiasis and oral mucositis. Results: 82.9% of the sample was composed of males and 17.1% females, mean age 58.2 years. It is possible to observe an occurrence of oral mucositis (74.28%), dysphagia (60%), candidiasis (40%) and, in a smaller number, dysgeusia (22.85%) and xerostomia (14.28%) the occurrence of oral mucositis in the head and neck region may be observed. Conclusion: head and neck radiotherapy, although presenting as an efficient therapeutic modality for malignant neoplasms, is usually associated with a series of complications in the irradiated region. In the studied sample, oral mucositis was the most prevalent comorbidity, followed by dysphagia and candidiasis.
Assuntos
RadioterapiaRESUMO
PURPOSE: Acute hemorrhage associated with cancers of the head and neck is a life-threatening condition that requires immediate action. The aim of this study was to assess the safety and efficacy of endovascular embolization for acute hemorrhage in patients with head and neck cancers. MATERIALS AND METHODS: Data were retrospectively collected from patients with head and neck cancers who underwent endovascular embolization to treat acute hemorrhage. The primary endpoint was the rate of immediate control of hemorrhage during the first 24 h after embolization. The secondary endpoints were technical or clinical complications, rate of re-hemorrhage 24 h after the procedure, time from embolization to re-hemorrhage, hospitalization time, mortality rate, and time from embolization to death. RESULTS: Fifty-one patients underwent endovascular embolization. The primary endpoint was achieved in 94% of patients. The rate of technical complications was 5.8%, and no clinical complication was observed. Twelve patients (23.5%) had hemorrhage recurrence after an average time of 127.5 days. The average hospitalization time was 7.4 days, the mortality rate during the follow-up period was 66.6%, and the average time from embolization to death was 132.5 days. CONCLUSION: Endovascular embolization to treat acute hemorrhage in patients with head and neck cancers is a safe and effective method for the immediate control of hemorrhage and results in a high rate of hemorrhage control. Larger studies are necessary to determine which treatment strategy is best for improving patient outcomes.
Assuntos
Embolização Terapêutica/métodos , Procedimentos Endovasculares/métodos , Neoplasias de Cabeça e Pescoço/complicações , Hemorragia/etiologia , Hemorragia/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Introduction/Objectives: To assess the efficacy and correlation of MDCT scans in the clinical staging of patients with HNCs prior to therapeutic intervention. Methodology: Thirty-four HNCs were studied according to the 2005 WHO. Clinical AJCC 6th edition & radiological staging. Results: 14 Squamous Cell Carcinoma (SCC 41.2%) mean age 49.4 + 14.7 years, 13 Nasopharyngeal Carcinoma (NPC 38.2%) mean age 37.1 + 20.5 years, 3 Odontogenic Carcinoma (ODC 8.8% made up of 2 cases ameloblastic carcinoma 5.9% and 1 case of ameloblastic carcinosarcoma 2.9%). Others cases were 3 Adenocarcinoma (8.8%) and 1 Sinonasal Carcinoma NC (2.9%). Mean age insignificant according to gender (p = 0.342). Sensitivity, specificity, positive & negative predictive values and accuracy of clinical and radiological nodal involvements were: (47.4%; 80%; 61.8%; 75%; 54.5%) & (78.9%; 93.3%; 85.3%; 93.8%; 77.8%) respectively. Difference between clinical and radiological stages was statistically significant (X2= 260.8; p=0.01). There was a low but positive correlation between the clinical and radiologic stages (Pearson's correlation r = 0.6). Conclusion: MDCT was significantly more accurate than clinical examination in the TNM of HNCs using AJCC/UICC TNM guidelines. Authors recommend MDCT as first line imaging technique in resource limited settings (AU)