The multidrug nature of anticancer treatment and different treatment protocols used in the studies are likely to be a major limitation in establishing real risk factors determining the occurrence of dental abnormalities. The authors aimed to establish a relationship between the duration and the dose of chemotherapy and the number of tooth adverse effects in the group receiving the same treatment. Of the 40 anticancer therapy recipients who attended the outpatient dental clinic, 7 leukemia survivors receiving the treatment according to the ALL IC-BFM 2002 protocol were selected. The study group consisted of four females and three males aged 92 to 207 months at the time of dental examination and 29 to 91 months at leukemia diagnosis. As a result of the clinical and radiological examination, dental abnormalities such as agenesis, tooth size reduction, root abnormalities, and taurodontia were identified, and the medical records of all survivors were reviewed in terms of drugs administered, their doses, and treatment schedules. No correlation was observed between the treatment duration of an intensive therapy, the entire therapy, and the number of tooth abnormalities. No relationship was also found between the number of dental abnormalities and the cumulative dose of vincristine, L-asparaginase, methotrexate, cyclophosphamide, cytarabine, and 6-mercaptopurine. The age at the onset of antineoplastic therapy is likely to be the strongest risk factor for toxic injury during tooth development.
抗癌治疗的多药性以及研究中采用的不同治疗方案，很可能成为确定导致牙齿异常发生真实风险因素的主要限制。本研究旨在探究接受相同治疗的患者群体中，化疗持续时间、剂量与牙齿不良反应数量之间的关系。从就诊于牙科门诊的40名抗癌治疗接受者中，筛选出7名按照ALL IC-BFM 2002方案接受治疗的白血病幸存者。研究组包括4名女性和3名男性，牙科检查时年龄为92至207个月，白血病确诊时年龄为29至91个月。通过临床和放射学检查，识别出牙齿发育不全、牙齿尺寸减小、牙根异常及牛牙症等牙齿异常情况，并审查了所有幸存者的医疗记录，包括所用药物、剂量及治疗方案。结果显示，强化治疗持续时间、整体治疗持续时间与牙齿异常数量之间未观察到相关性。牙齿异常数量与长春新碱、L-天冬酰胺酶、甲氨蝶呤、环磷酰胺、阿糖胞苷及6-巯基嘌呤的累积剂量之间也未发现关联。抗肿瘤治疗开始时的年龄可能是牙齿发育过程中毒性损伤最强的风险因素。
Tooth Abnormalities and Their Age-Dependent Occurrence in Leukemia Survivors
肿瘤(癌症)患者之家