Long-term Oral Complications of an Established Head and Neck Cancer Cohort- Clinical Registry of Dental Outcomes in Head and Neck Cancer Patients: OraRad

已建立的头颈癌队列的长期口腔并发症 - 头颈癌患者牙科结果的临床登记：OraRad

• 批准号: 10693394
• 负责人: MICHAEL T BRENNAN
• 金额: $ 122万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-26 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10693394
• 关键词: Adverse effects; Cancer Survivorship; Clinical; Data; Dental; Dental Care; Dental Hygiene; Dental Insurance; Dental caries; Development; Disease; Dose; Education; Female; Fluorides; Head and Neck Cancer; Health; Impairment; Incidence; Measures; Modality; Modeling; Modernization; Morbidity - disease rate; Multicenter Studies; National Institute of Dental and Craniofacial Research; Oral; Oral Examination; Oral cavity; Osteoradionecrosis; Outcome; Participant; Patient Self-Report; Patients; Periodontal Diseases; Prevention strategy; Prospective Studies; Prospective, cohort study; Public Health; Radiation; Radiation Dose Unit; Radiation therapy; Records; Registries; Research; Retrospective Studies; Risk; Risk Assessment; Risk Factors; Salivary; Salivary Glands; Sampling; Socioeconomic Status; Strategic Planning; Surface; Survivors; Time; Tissues; Tooth Loss; Tooth structure; Toothache; Translational Research; Visit; Xerostomia; bone; chemotherapy; clinical investigation; cohort; craniofacial; evidence base; follow-up; head and neck cancer patient; healing; high risk; higher education; improved; innovation; low socioeconomic status; maxillofacial; prospective; sex

PROJECT SUMMARY/ABSTRACT Most head and neck cancer (HNC) patients receive high-dose radiation therapy (RT), which has significant, sometimes life-long, adverse effects on oral and maxillofacial tissues. Damage to salivary glands frequently leads to hyposalivation, increasing the risk of dental caries and tooth loss post-radiation. Furthermore, radiation impairs the ability of bone to heal, leading to a life- long risk of osteoradionecrosis (ORN), which presents as exposed intraoral bone and is often precipitated by dental extractions. Consequently, HNC patients are caught in a vicious circle, being at higher risk of needing dental extractions, but with extractions to be avoided post-RT due to the risk for ORN. A multi-center prospective cohort study, Clinical Registry of Dental Outcomes in Head and Neck Cancer Patients (OraRad), was established to examine the incidence of oral complications after RT and associated risk factors in HNC patients. The OraRad cohort of 572 participants was followed for 24 months with incidence and risk factors of short-term oral complications identified. The overall objective of the current proposal is to assess OraRad participants at 7 years post-RT and identify the long-term incidence and risk factors of oral complications in this cohort. We will accomplish this objective by pursuing the following specific aims: 1) Determine the long-term incidence of dental caries, periodontal disease, tooth loss and osteoradionecrosis, up to 7 years after RT for HNC patients and 2) Determine the risk factors associated with high and low incidence of long-term oral complications and develop a multiple variable model of risk. We will accomplish these aims by having current OraRad participants return for a clinical oral examination at about 7 years post- RT. We anticipate 350 long-term OraRad survivors will be evaluated at this follow-up visit. The proposed research is innovative because this is the first prospective multi-center study with a large enough sample to identify risk factors associated with long-term adverse dental outcomes in HNC patients after modern RT. Our strong data on the incidence and risk factors of oral complications for the initial OraRad 24-month study period clearly demonstrate the feasibility of achieving these aims. This study is highly significant because it will directly provide data to facilitate evidence-based dental management of patients receiving current modalities of RT for HNC.

项目摘要/摘要 大多数头颈癌（HNC）患者接受高剂量放射疗法（RT），该疗法具有 对口腔和上颌面组织的显着，有时是终身的不利影响。损坏 唾液腺经常导致缺乏症，增加龋齿和牙齿的风险 放射后损失。此外，辐射会损害骨骼愈合的能力，导致生命 - 长期存在骨气造成的风险（ORN），其呈暴露的骨内骨，通常是 由牙齿提取引起。因此，HNC患者被捕获在恶性循环中， 需要提取牙齿的风险更高，但要避免提取后-RT 由于有ORN的风险。牙科临床注册表的多中心前瞻性队列研究 建立了头颈癌患者（ORARAD）的结果以检查 HNC患者的RT和相关危险因素后口服并发症发生率。这 遵循572名参与者的Orarad队列24个月，发病率和风险因素 鉴定出短期口服并发症。当前建议的总体目标是 在RT后7年评估Orarad参与者，并确定长期发病率和风险 该队列中口服并发症的因素。我们将通过追求 以下特定目的：1）确定龋齿，牙周的长期发病率 HNC患者RT后长达7年，2） 确定与长期口腔高发病率相关的危险因素 并发症并开发多个可变风险模型。我们将通过 当前的Orarad参与者在大约7年后返回临床口腔检查 - RT。我们预计将在此后续访问中评估350个长期的Orarad幸存者。这 拟议的研究具有创新性，因为这是第一项前瞻性多中心研究 足够大的样本以识别与长期不良牙齿结果相关的危险因素 现代RT后HNC患者。我们关于口服发病率和危险因素的强大数据 初始Orarad 24个月研究期的并发症清楚地表明了 实现这些目标。这项研究非常重要，因为它将直接提供数据 促进接受RT的当前患者的循证牙科管理 HNC。

项目成果

Epidemiologic factors in patients with advanced head and neck cancer treated with radiation therapy.

• DOI: 10.1002/hed.26468
• 发表时间: 2021-01
• 期刊: Head & neck
• 作者: Brennan MT;Treister NS;Sollecito TP;Schmidt BL;Patton LL;Yang Y;Lin A;Elting LS;Hodges JS;Lalla RV
• 通讯作者: Lalla RV

Oncologists' Perspective on Dental Care Around the Treatment of Head and Neck Cancer: A Pattern of Practice Survey.

肿瘤学家对头颈癌治疗牙科护理的看法：实践调查模式。

• DOI: 10.1200/op.20.00913
• 发表时间: 2022
• 期刊: JCO oncology practice
• 影响因子: 4
• 作者: Ward,MatthewC;Carpenter,MichaelD;Noll,Jenene;Carrizosa,Daniel;Moeller,BenjaminJ;Helgeson,ErikaS;Lalla,RajeshV;Brennan,MichaelT
• 通讯作者: Brennan,MichaelT

Survey of experiences and barriers to dental care post-head and neck cancer in OraRad study participants.

OraRad 研究参与者头颈癌后牙科护理经历和障碍的调查。

• DOI: 10.1016/j.oooo.2022.11.011
• 发表时间: 2023
• 期刊: Oral surgery, oral medicine, oral pathology and oral radiology
• 作者: Threet,EJackson;Napeñas,JoelJ;Petersen,Cathleen;Mitchell,Rebecca;Long-Simpson,Leslie;Shadick,Ryann;Valentino,KimberlyC;Rybczyk,CynthiaA;Blake,Jo-AnnA;Brown,MakedaC;Aidoo,Robert;Helgeson,ErikaS;Lalla,RajeshV;Brennan,Micha
• 通讯作者: Brennan,Micha

Tooth-level predictors of tooth loss and exposed bone after radiation therapy for head and neck cancer.

• DOI: 10.1016/j.adaj.2023.03.009
• 发表时间: 2023-06
• 期刊: Journal of the American Dental Association (1939)

Reduced mouth opening in patients with head and neck cancer treated with radiation therapy: an analysis of the Clinical Registry of Dental Outcomes in Head and Neck Cancer Patients (OraRad).

接受放射治疗的头颈癌患者张口减少：对头颈癌患者牙科结果临床登记 (OraRad) 的分析。

• DOI: 10.1016/j.oooo.2023.11.012
• 发表时间: 2024
• 期刊: Oral surgery, oral medicine, oral pathology and oral radiology
• 作者: Sollecito,ThomasP;Helgeson,ErikaS;Lalla,RajeshV;Treister,NathanielS;Schmidt,BrianL;Patton,LaurenL;Lin,Alexander;Brennan,MichaelT
• 通讯作者: Brennan,MichaelT