RADIOTERAPIA DE CABEÇA E PESCOÇO: COMPLICAÇÕES BUCAIS E ATUAÇÃO DO CIRURGIÃO-DENTISTA
Resumo
O câncer é a segunda maior causa de morte no Brasil, estando as neoplasias de cabeça e pescoço em 5º lugar entre os tumores mais comuns do mundo. O tratamento das doenças malignas varia em função do tipo e da fase de estadiamento. A radioterapia é indicada em um número significativo de casos de câncer de cabeça e pescoço, tendo como principal objetivo o de destruir as células cancerígenas. Contudo, a radiação também afeta as células normais e resulta em reações bucais indesejáveis ao paciente. Dentre as complicações da radioterapia, destacamse a xerostomia, mucosite, cárie por radiação, disgeusia, trismo e a osteorradionecrose. Objetivo: O objetivo do presente estudo é compilar as complicações bucais da radioterapia e alguns protocolos de tratamento pré, trans e pós-terapia, por meio de um levantamento bibliográfico e do embasamento científico. Metodologia: Este artigo foi realizado a partir de uma busca textual nas plataformas virtuais Pubmed, Scielo, Google Acadêmico e em livros de odontologia. Conclusão: A literatura sugere que um tratamento multidisciplinar que aborde medidas preventivas, a adequação do meio bucal e o acompanhamento dos pacientes durante todo o tratamento oferece benefícios e pode prevenir, minimizar ou até mesmo eliminar as complicações bucais resultantes da radiação. Palavras-Chave: Câncer de cabeça e pescoço. Radioterapia. Complicações bucais da radiação. Osteorradionecrose. Prevenção. Tratamento. Controle.Referências
ALBUQUERQUE, R. A.; MORAIS, V. L. L.; SOBRAL, A. P. V. Protocolo de atendimento odontológico a pacientes oncológicos pediátricos – revisão da literatura. Revista de Odontologia da UNESP, v. 36, p. 275-280, 2007.
ANDRADE, E. D. Terapêutica medicamentosa em odontologia. 3 ed. São Paulo, SP: Artes Médicas, 1999.
ANDREWS, N.; GRIFFTHS, C. Dental complications of head and neck radiotherapy: Part 1. Australian Dental Journal, v. 46, n. 2, p. 88-94, 2001.
ANDREWS, N.; GRIFFTHS, C. Dental complications of head and neck radiotherapy: Part 2. Australian Dental Journal, v. 46, n. 3, p. 174-182, 2001.
BEECH, N.; ROBINSON, S.; PORCEDDU, S., et al. Dental management of patients irradiated for head and neck cancer. Australian Dental Journal, v. 59, n. 1, p. 20-28, 2014.
BEN-DAVID, M. A.; DIAMANTE, M.; RADAWSKI, J. D., et al. Lack of osteoradionecrosis of the mandible after intensity-modulated radiotherapy for head and neck cancer: likely contributions of both dental care and improved dose distributions. International Journal of Radiation Oncology, v. 68, p. 396-402, 2007.
BEN-DAVID, M. A.; DIAMANTE, M.; RADAWSKI, J. D., et al. Lack of osteoradionecrosis of the mandible after intensity-modulated radiotherapy for head and neck cancer: likely contributions of both dental care and improved dose distributions. International Journal of Radiation Oncology * Biology * Physics, v. 68, p. 396-402, 2007.
BENNETT, M. H.; FELDMEIER, J.; HAMPSON, N. B., et al. Hyperbaric oxygen therapy for late radiation tissue injury. Cochrane Database Systematic Reviews, 2016.
BUENO, A. C.; FERREIRA, R. C.; BARBOSA, F. I., et al. Periodontal care in patients undergoing radiotherapy for head and neck cancer. Support Care Cancer, v. 21, n. 4, p. 969-975, 2013.
CAMPOS VELO, M. M. A.; FARHA, A. L. H.; SANTOS, P. S. DA S., et al. Gamma radiation increases the risk of radiation-related root dental caries. Oral Oncology, v. 22, S1368-8375, n. 17, p. 30159-30168, 2017.
CAPARROTTI, F.; HUANG, S. H.; LU, L., et al. Osteoradionecrosis of the mandible in patients with oropharyngeal carcinoma treated with intensity-modulated radiotherapy. Cancer, v. 13, 2017.
CARDONA, A.; BALOUCH, A.; ABDUL, M. M., et al. Efficacy of chlorhexidine for the prevention and treatment of oral mucositis in cancer patients: a systematic review with meta-analyses. Journal of Oral Pathology & Medicine, 2017.
CHOUINARD, A. F.; GIASSON, L.; FORTIN, M. Hyperbaric oxygen therapy for head and neck irradiated patients with special attention to oral and maxillofacial treatments. Journal Canadian Dental Association, v. 82, n. g24, p. 1-5, 2016.
DE SANCTIS, V.; BOSSI, P.; SANGUINETI, G., et al. Mucositis in head and neck cancer patients treated with radiotherapy and systemic therapies: Literature review and consensus statements. Critical Reviews in Oncology/ Hematology, v. 100, p. 147-166, 2016.
DENG, J.; JACKSON, L.; EPSTEIN, J. B., et al. Dental demineralization and caries in patients with head and neck cancer. Oral Oncology, v. 51, n. 9, p. 824-831, 2015.
DIB, L. L.; GONÇALVES, R. C. C.; KOWALSKI, L. P., et al. Abordagem multidisciplinar das complicações orais da radioterapia. Revista da Associação Paulista de Cirurgiões Dentistas, v. 54, p. 391-396, 2000.
Ciência Atual | Rio de Janeiro | Volume 10, Nº 2 • 2017 | inseer.ibict.br/cafsj | Pg. 12-15
REFERÊNCIAS BIBLIOGRÁFICAS
DIJKSTRA, P. U; KALK, W. W; ROODENBURG, J. L. Trismus in head and neck oncology: a systematic review. Oral Oncology, v. 40, n. 9, p. 879-889, 2004.
EPSTEIN, J. B.; ROBERTSON, M.; EMERTON, S., et al. Quality of life and oral function in patients treated with radiation therapy for head and neck cancer. Head & Neck, v. 23, p. 389-398, 2001.
ESPENEL, S.; RAFFOUX, C.; VALLARD, A., et al. Hyperbaric oxygen and radiotherapy: From myth to reality. Cancer Radiotherapy, v. 20, n. 5, p. 416-421, 2016.
FALONI, A. P. S.; LORENZON, A. P.; MARGONAR, R., et al. Importância dos procedimentos periodontais prévios à radioterapia em região de cabeça e pescoço. Revista Internacional de Periodontia Clínica, v. 2, p. 93-99, 2005.
GRIMALDI, N.; SARMENTO, V.; PROVEDEL, L., et al. Conduta do cirurgião dentista na prevenção e tratamento da osteorradionecrose. Revista brasileira de cancerologia, v. 51, n. 4, p. 319-324, 2005.
GUPTA, N.; PAL, M.; RAWAT, S., et al. Radiation-induced dental caries, prevention and treatment - A systematic review. National Journal of Maxillofacial Surgery, v. 6, n. 2, p. 160-166, 2015.
HANLEY, M.; COOPER, J. Osteorradionecrosis. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2017.
HEIJNEN, B. J.; SPEYER, R.; KERTSCHER, B., et al. Dysphagia, Speech, Voice, and Trismus following Radiotherapy and/or Chemotherapy in Patients with Head and Neck Carcinoma: Review of the Literature. BioMed Research International, 2016.
HUBER, M. A.; TEREZHALMY, G. T. The head and neck radiation oncology patient. Quintessence International, v. 34, p. 693-717, 2003.
HUPP, J. R.; TUCKER, M. R.; ELLIS III, E. Contemporary Oral and Maxillofacial Surgery. 6th ed. Amsterdã: Elsevier, 2014.
INSTITUTO NACIONAL DO CÂNCER. (Virtual Book, 2015) Estimativa de incidência de câncer no Brasil. Disponível em: http://www.inca.gov.com.br, Acessado: 25/11/2016.
JHAM, B. C.; DA SILVA FREIRE, A. R. Oral complications of radiotherapy in the head and neck. Brazilian Journal of Otorhinolaryngology, v. 72, n. 5, p. 704-708, 2006.
JHAM, C. B.; FREIRE, A. R. S. Complicações bucais de radioterapia em cabeça e pescoço. Revista brasileira de otorrinolaringologia, v. 72, n. 5, p. 704-708, 2006.
KOJIMA, Y.; YANAMOTO, S.; UMEDA, M., et al. Relationship between dental status and development of osteoradionecrosis of the jaw: a multicenter retrospective study. Oral Surgery Oral Medicine Oral Pathology Oral Radiology, v. 4, S2212-4403, n. 17, 2017.
LERMAN, M. A.; LAUDENBACH, J.; MARTY, F. M., et al. Management of oral infections in cancer patients. Dental Clinics of North America, v. 52, p. 129-153, 2008.
LINDHE, J.; LANG, N. P. Clinical Periodontology and Implant Dentistry. 6th ed. Nova Jersey: Wiley Blackwell, 2015.
LOH, S. Y.; MCLEOD, R. W. J.; ELHASSAN, H. A. Trismus following different treatment modalities for head and neck cancer: a systematic review of subjective measures. European Archives of Oto-Rhino-Laryngology, v. 274, n. 7, p. 2695-2707, 2017.
Ciência Atual | Rio de Janeiro | Volume 10, Nº 2 • 2017 | inseer.ibict.br/cafsj | Pg. 13-15
REFERÊNCIAS BIBLIOGRÁFICAS
MALLICK, S.; BENSON, R.; RATH, G. K. Radiation induced oral mucositis: a review of current literature on prevention and management. European Archives of Oto-Rhino-Laryngology, v. 273, n. 9, p. 2285-2293, 2016.
MARIA, O. M.; ELIOPOULOS, N.; MUANZA, T. Radiation-Induced Oral Mucositis. Frontiers in Oncology, v. 22, n. 7, p. 89, 2017.
MATSUZAKI, H.; TANAKA-MATSUZAKI, K.; MIYAZAKI, F., et al. The role of dentistry other than oral care in patients undergoing radiotherapy for head and neck cancer. Japanese Dental Science Review, v. 53, n. 2, p. 46-52, 2017.
MCCAUL, J. A. Pharmacologic modalities in the treatment of osteoradionecrosis of the jaw. Oral & Maxillofacial Surgery Clinics of North America, v. 26, n. 2, p. 247-252, 2014.
MERCADANTE, V.; AL HAMAD, A.; LODI, G., et al. Interventions for the management of radiotherapy-induced xerostomia and hyposalivation: A systematic review and meta-analysis. Oral Oncology, v. 66, p. 64-74, 2017.
NEVILLE, B. W.; DAMM, D. D. Oral and maxillofacial pathology. 4th ed. Amsterdã: Elsevier, 2015.
OTMANI, N. Oral and maxillofacial side effects of radiation therapy onchildren. Journal Canadian Dental Association, v. 73, n. 3, p. 257-261, 2007.
PAIVA, M. D. E. B.; BIASE, R. C. C. G.; MORAES, J. J. C., et al. Complicações Orais Decorrente da Terapia Antineoplasicas. Arquivos em odontologia, v. 46, n. 1, p. 48-55, 2010.
REID, P. A.; WILSON, P.; LI, Y., et al. Current understanding of cancer stem cells: Review of their radiobiology and role in head and neck cancers. Head & Neck, 2017.
RICE, N.; POLYZOIS, I.; EKANAYAKE, K., et al. The management of osteoradionecrosis of the jaws--a review. Surgeon, v. 13, n. 2, p.101-109, 2015.
SAWADA, N. O.; DIAS, A. M.; ZAGO, M. M. F. O efeito da radioterapia sobre a qualidade de vida dos pacientes com câncer de cabeça e pescoço. Revista Brasileira de Cancerologia, v. 52, n. 4, p. 323-329, 2006.
SCHIFF, A. B. Overview of Head and Neck Tumors. Virtual Book, 2016. Disponível em: <http://www.merckmanuals.com.br>. Acessado em: 13\03\2017.
SHIBOSKI, C. H.; HODGSON, T. A.; SHIP, J. A., et al. Management of salivary hypofunction during and after radiotherapy. Oral Surgery Oral Medicine Oral Patholology Oral Radiology and Endodontics, v. 103, Supply, p. S66.e1-19, 2007.
SILVERMAN JR., S. Oral cancer: complications of therapy. Oral Surgery Oral Medicine Oral Patholology Oral Radiology and Endodontics, v. 88, p. 122-126, 1999.
SKIBA-TATARSKA, M.; KUSA-PODKA?SKA, M.; SURTEL, A., et al. The side-effects of head and neck tumors radiotherapy. Polski Merkuriusz Lekarski, v. 41, n. 241, p. 47-49, 2016.
SULTAN, A.; HANNA, G. J.; MARGALIT, D. N., et al. The Use of Hyperbaric Oxygen for the Prevention and Management of Osteoradionecrosis of the Jaw: A Dana-Farber/Brigham and Women’s Cancer Center Multidisciplinary Guideline. Oncologist, v. 22, n. 3, p. 343-350, 2017.
Ciência Atual | Rio de Janeiro | Volume 10, Nº 2 • 2017 | inseer.ibict.br/cafsj | Pg. 14-15
REFERÊNCIAS BIBLIOGRÁFICAS
TANAKA, T. I.; CHAN, H.L.; TINDLE, D. I., et al. Updated clinical considerations for dental implant therapy in irradiated head and neck cancer patients. Journal of Prosthodontics, v. 22, n. 6, p. 432-438, 2013.
THORN, J. J.; HANSEN, H. S.; SPECHT, L., et al. Osteoradionecrosis of the jaws: clinical characteristics and relation to the field of irradiation. Journal of Oral and Maxillofacial Surgery, v. 58, p. 1088-1093, 2000.
TOLENTINO, E. S.; CENTURION, B. S.; FERREIRA, L. H. C., et al. Oral adverse effects of head and neck radiotherapy: literature review and suggestion of a clinical oral care guideline for irradiated patients. Journal of Applied Oral Science, v. 19, n. 5, p. 448-454, 2011.
VAN BOKHORST-DE VAN DER SCHUEREN, M. A. Nutritional support strategies for malnourished cancer patients. European Journal of Oncology Nursing, v. 9, Supply 2, p. S74-83, 2005.
VIGARIOS, E.; EPSTEIN, J. B.; SIBAUD, V. Oral mucosal changes induced by anticancer targeted therapies and immune checkpoint inhibitors. Support Care Cancer, v. 25, n. 5, p. 1713-1739, 2017.
VISSINK, A.; JANSMA, J.; SPIJKERVET, F. K., et al. Oral sequelae of head and neck radiotherapy. Critical Reviews in Oral Biology & Medicine, v. 14, p. 199-212, 2003.
VISSINK, A.; JANSMA, J.; SPIJKERVET, F. K., et al. Oral sequelae of head and neck radiotherapy. Critical Reviews in Oral Biology & Medicine, v. 14, p. 199-212, 2003.
ANDRADE, E. D. Terapêutica medicamentosa em odontologia. 3 ed. São Paulo, SP: Artes Médicas, 1999.
ANDREWS, N.; GRIFFTHS, C. Dental complications of head and neck radiotherapy: Part 1. Australian Dental Journal, v. 46, n. 2, p. 88-94, 2001.
ANDREWS, N.; GRIFFTHS, C. Dental complications of head and neck radiotherapy: Part 2. Australian Dental Journal, v. 46, n. 3, p. 174-182, 2001.
BEECH, N.; ROBINSON, S.; PORCEDDU, S., et al. Dental management of patients irradiated for head and neck cancer. Australian Dental Journal, v. 59, n. 1, p. 20-28, 2014.
BEN-DAVID, M. A.; DIAMANTE, M.; RADAWSKI, J. D., et al. Lack of osteoradionecrosis of the mandible after intensity-modulated radiotherapy for head and neck cancer: likely contributions of both dental care and improved dose distributions. International Journal of Radiation Oncology, v. 68, p. 396-402, 2007.
BEN-DAVID, M. A.; DIAMANTE, M.; RADAWSKI, J. D., et al. Lack of osteoradionecrosis of the mandible after intensity-modulated radiotherapy for head and neck cancer: likely contributions of both dental care and improved dose distributions. International Journal of Radiation Oncology * Biology * Physics, v. 68, p. 396-402, 2007.
BENNETT, M. H.; FELDMEIER, J.; HAMPSON, N. B., et al. Hyperbaric oxygen therapy for late radiation tissue injury. Cochrane Database Systematic Reviews, 2016.
BUENO, A. C.; FERREIRA, R. C.; BARBOSA, F. I., et al. Periodontal care in patients undergoing radiotherapy for head and neck cancer. Support Care Cancer, v. 21, n. 4, p. 969-975, 2013.
CAMPOS VELO, M. M. A.; FARHA, A. L. H.; SANTOS, P. S. DA S., et al. Gamma radiation increases the risk of radiation-related root dental caries. Oral Oncology, v. 22, S1368-8375, n. 17, p. 30159-30168, 2017.
CAPARROTTI, F.; HUANG, S. H.; LU, L., et al. Osteoradionecrosis of the mandible in patients with oropharyngeal carcinoma treated with intensity-modulated radiotherapy. Cancer, v. 13, 2017.
CARDONA, A.; BALOUCH, A.; ABDUL, M. M., et al. Efficacy of chlorhexidine for the prevention and treatment of oral mucositis in cancer patients: a systematic review with meta-analyses. Journal of Oral Pathology & Medicine, 2017.
CHOUINARD, A. F.; GIASSON, L.; FORTIN, M. Hyperbaric oxygen therapy for head and neck irradiated patients with special attention to oral and maxillofacial treatments. Journal Canadian Dental Association, v. 82, n. g24, p. 1-5, 2016.
DE SANCTIS, V.; BOSSI, P.; SANGUINETI, G., et al. Mucositis in head and neck cancer patients treated with radiotherapy and systemic therapies: Literature review and consensus statements. Critical Reviews in Oncology/ Hematology, v. 100, p. 147-166, 2016.
DENG, J.; JACKSON, L.; EPSTEIN, J. B., et al. Dental demineralization and caries in patients with head and neck cancer. Oral Oncology, v. 51, n. 9, p. 824-831, 2015.
DIB, L. L.; GONÇALVES, R. C. C.; KOWALSKI, L. P., et al. Abordagem multidisciplinar das complicações orais da radioterapia. Revista da Associação Paulista de Cirurgiões Dentistas, v. 54, p. 391-396, 2000.
Ciência Atual | Rio de Janeiro | Volume 10, Nº 2 • 2017 | inseer.ibict.br/cafsj | Pg. 12-15
REFERÊNCIAS BIBLIOGRÁFICAS
DIJKSTRA, P. U; KALK, W. W; ROODENBURG, J. L. Trismus in head and neck oncology: a systematic review. Oral Oncology, v. 40, n. 9, p. 879-889, 2004.
EPSTEIN, J. B.; ROBERTSON, M.; EMERTON, S., et al. Quality of life and oral function in patients treated with radiation therapy for head and neck cancer. Head & Neck, v. 23, p. 389-398, 2001.
ESPENEL, S.; RAFFOUX, C.; VALLARD, A., et al. Hyperbaric oxygen and radiotherapy: From myth to reality. Cancer Radiotherapy, v. 20, n. 5, p. 416-421, 2016.
FALONI, A. P. S.; LORENZON, A. P.; MARGONAR, R., et al. Importância dos procedimentos periodontais prévios à radioterapia em região de cabeça e pescoço. Revista Internacional de Periodontia Clínica, v. 2, p. 93-99, 2005.
GRIMALDI, N.; SARMENTO, V.; PROVEDEL, L., et al. Conduta do cirurgião dentista na prevenção e tratamento da osteorradionecrose. Revista brasileira de cancerologia, v. 51, n. 4, p. 319-324, 2005.
GUPTA, N.; PAL, M.; RAWAT, S., et al. Radiation-induced dental caries, prevention and treatment - A systematic review. National Journal of Maxillofacial Surgery, v. 6, n. 2, p. 160-166, 2015.
HANLEY, M.; COOPER, J. Osteorradionecrosis. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2017.
HEIJNEN, B. J.; SPEYER, R.; KERTSCHER, B., et al. Dysphagia, Speech, Voice, and Trismus following Radiotherapy and/or Chemotherapy in Patients with Head and Neck Carcinoma: Review of the Literature. BioMed Research International, 2016.
HUBER, M. A.; TEREZHALMY, G. T. The head and neck radiation oncology patient. Quintessence International, v. 34, p. 693-717, 2003.
HUPP, J. R.; TUCKER, M. R.; ELLIS III, E. Contemporary Oral and Maxillofacial Surgery. 6th ed. Amsterdã: Elsevier, 2014.
INSTITUTO NACIONAL DO CÂNCER. (Virtual Book, 2015) Estimativa de incidência de câncer no Brasil. Disponível em: http://www.inca.gov.com.br, Acessado: 25/11/2016.
JHAM, B. C.; DA SILVA FREIRE, A. R. Oral complications of radiotherapy in the head and neck. Brazilian Journal of Otorhinolaryngology, v. 72, n. 5, p. 704-708, 2006.
JHAM, C. B.; FREIRE, A. R. S. Complicações bucais de radioterapia em cabeça e pescoço. Revista brasileira de otorrinolaringologia, v. 72, n. 5, p. 704-708, 2006.
KOJIMA, Y.; YANAMOTO, S.; UMEDA, M., et al. Relationship between dental status and development of osteoradionecrosis of the jaw: a multicenter retrospective study. Oral Surgery Oral Medicine Oral Pathology Oral Radiology, v. 4, S2212-4403, n. 17, 2017.
LERMAN, M. A.; LAUDENBACH, J.; MARTY, F. M., et al. Management of oral infections in cancer patients. Dental Clinics of North America, v. 52, p. 129-153, 2008.
LINDHE, J.; LANG, N. P. Clinical Periodontology and Implant Dentistry. 6th ed. Nova Jersey: Wiley Blackwell, 2015.
LOH, S. Y.; MCLEOD, R. W. J.; ELHASSAN, H. A. Trismus following different treatment modalities for head and neck cancer: a systematic review of subjective measures. European Archives of Oto-Rhino-Laryngology, v. 274, n. 7, p. 2695-2707, 2017.
Ciência Atual | Rio de Janeiro | Volume 10, Nº 2 • 2017 | inseer.ibict.br/cafsj | Pg. 13-15
REFERÊNCIAS BIBLIOGRÁFICAS
MALLICK, S.; BENSON, R.; RATH, G. K. Radiation induced oral mucositis: a review of current literature on prevention and management. European Archives of Oto-Rhino-Laryngology, v. 273, n. 9, p. 2285-2293, 2016.
MARIA, O. M.; ELIOPOULOS, N.; MUANZA, T. Radiation-Induced Oral Mucositis. Frontiers in Oncology, v. 22, n. 7, p. 89, 2017.
MATSUZAKI, H.; TANAKA-MATSUZAKI, K.; MIYAZAKI, F., et al. The role of dentistry other than oral care in patients undergoing radiotherapy for head and neck cancer. Japanese Dental Science Review, v. 53, n. 2, p. 46-52, 2017.
MCCAUL, J. A. Pharmacologic modalities in the treatment of osteoradionecrosis of the jaw. Oral & Maxillofacial Surgery Clinics of North America, v. 26, n. 2, p. 247-252, 2014.
MERCADANTE, V.; AL HAMAD, A.; LODI, G., et al. Interventions for the management of radiotherapy-induced xerostomia and hyposalivation: A systematic review and meta-analysis. Oral Oncology, v. 66, p. 64-74, 2017.
NEVILLE, B. W.; DAMM, D. D. Oral and maxillofacial pathology. 4th ed. Amsterdã: Elsevier, 2015.
OTMANI, N. Oral and maxillofacial side effects of radiation therapy onchildren. Journal Canadian Dental Association, v. 73, n. 3, p. 257-261, 2007.
PAIVA, M. D. E. B.; BIASE, R. C. C. G.; MORAES, J. J. C., et al. Complicações Orais Decorrente da Terapia Antineoplasicas. Arquivos em odontologia, v. 46, n. 1, p. 48-55, 2010.
REID, P. A.; WILSON, P.; LI, Y., et al. Current understanding of cancer stem cells: Review of their radiobiology and role in head and neck cancers. Head & Neck, 2017.
RICE, N.; POLYZOIS, I.; EKANAYAKE, K., et al. The management of osteoradionecrosis of the jaws--a review. Surgeon, v. 13, n. 2, p.101-109, 2015.
SAWADA, N. O.; DIAS, A. M.; ZAGO, M. M. F. O efeito da radioterapia sobre a qualidade de vida dos pacientes com câncer de cabeça e pescoço. Revista Brasileira de Cancerologia, v. 52, n. 4, p. 323-329, 2006.
SCHIFF, A. B. Overview of Head and Neck Tumors. Virtual Book, 2016. Disponível em: <http://www.merckmanuals.com.br>. Acessado em: 13\03\2017.
SHIBOSKI, C. H.; HODGSON, T. A.; SHIP, J. A., et al. Management of salivary hypofunction during and after radiotherapy. Oral Surgery Oral Medicine Oral Patholology Oral Radiology and Endodontics, v. 103, Supply, p. S66.e1-19, 2007.
SILVERMAN JR., S. Oral cancer: complications of therapy. Oral Surgery Oral Medicine Oral Patholology Oral Radiology and Endodontics, v. 88, p. 122-126, 1999.
SKIBA-TATARSKA, M.; KUSA-PODKA?SKA, M.; SURTEL, A., et al. The side-effects of head and neck tumors radiotherapy. Polski Merkuriusz Lekarski, v. 41, n. 241, p. 47-49, 2016.
SULTAN, A.; HANNA, G. J.; MARGALIT, D. N., et al. The Use of Hyperbaric Oxygen for the Prevention and Management of Osteoradionecrosis of the Jaw: A Dana-Farber/Brigham and Women’s Cancer Center Multidisciplinary Guideline. Oncologist, v. 22, n. 3, p. 343-350, 2017.
Ciência Atual | Rio de Janeiro | Volume 10, Nº 2 • 2017 | inseer.ibict.br/cafsj | Pg. 14-15
REFERÊNCIAS BIBLIOGRÁFICAS
TANAKA, T. I.; CHAN, H.L.; TINDLE, D. I., et al. Updated clinical considerations for dental implant therapy in irradiated head and neck cancer patients. Journal of Prosthodontics, v. 22, n. 6, p. 432-438, 2013.
THORN, J. J.; HANSEN, H. S.; SPECHT, L., et al. Osteoradionecrosis of the jaws: clinical characteristics and relation to the field of irradiation. Journal of Oral and Maxillofacial Surgery, v. 58, p. 1088-1093, 2000.
TOLENTINO, E. S.; CENTURION, B. S.; FERREIRA, L. H. C., et al. Oral adverse effects of head and neck radiotherapy: literature review and suggestion of a clinical oral care guideline for irradiated patients. Journal of Applied Oral Science, v. 19, n. 5, p. 448-454, 2011.
VAN BOKHORST-DE VAN DER SCHUEREN, M. A. Nutritional support strategies for malnourished cancer patients. European Journal of Oncology Nursing, v. 9, Supply 2, p. S74-83, 2005.
VIGARIOS, E.; EPSTEIN, J. B.; SIBAUD, V. Oral mucosal changes induced by anticancer targeted therapies and immune checkpoint inhibitors. Support Care Cancer, v. 25, n. 5, p. 1713-1739, 2017.
VISSINK, A.; JANSMA, J.; SPIJKERVET, F. K., et al. Oral sequelae of head and neck radiotherapy. Critical Reviews in Oral Biology & Medicine, v. 14, p. 199-212, 2003.
VISSINK, A.; JANSMA, J.; SPIJKERVET, F. K., et al. Oral sequelae of head and neck radiotherapy. Critical Reviews in Oral Biology & Medicine, v. 14, p. 199-212, 2003.
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