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Master's Dissertation
DOI
https://doi.org/10.11606/D.25.2023.tde-09112023-093502
Document
Author
Full name
Thais de Moraes Souza
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2023
Supervisor
Committee
Honório, Heitor Marques (President)
Bullen, Izabel Regina Fischer Rubira de
Pinheiro, Helder Henrique Costa
Pontes, Flavia Sirotheau Corrêa
Title in Portuguese
Prevalência de complicações orais após radioterapia em câncer de cabeça e pescoço: uma revisão sistemática e meta-análise
Keywords in Portuguese
Doenças da boca
Neoplasias de cabeça e pescoço
Radioterapia
Abstract in Portuguese
Pacientes com câncer de cabeça e pescoço (CCP) que passam por tratamento radioterápico são mais suscetíveis ao comprometimento da sua saúde oral. Este estudo é uma revisão sistemática que tem como objetivo determinar a prevalência de complicações orais resultantes do tratamento radioterápico em pacientes com CCP. As buscas foram realizadas nas bases de dados PubMed/MEDLINE, BVS, EMBASE, Livivo, Web of Science, Scopus, Cochrane Library para incluir artigos até outubro de 2021. Também foram feitas buscas manuais na literatura cinzenta. Foram incluídos estudos observacionais transversais e de coorte que apresentam dados de pacientes com CCP tratados com radioterapia, independentemente da modalidade e do tempo pós-tratamento, com informações de prevalência sobre ageusia, doença periodontal, hipossalivação, xerostomia, osteorradionecrose (ORN), cárie por radiação e mucosite oral, além de dados sociodemográficas e clínicas dos pacientes. Para a extração de dados, apenas aqueles fornecidos nos artigos foram considerados. A análise do risco de viés dos estudos incluídos foi realizada a partir da ferramenta proposta pelo Instituto Joanna Briggs. Foi realizada uma síntese narrativa e os dados foram metanalizados por meio do modelo de efeito randômico, adotando-se um nível de significância de 5%. Foram incluídos 33 estudos (Kappa = 0.89), com um total de 4.166 pacientes com CCP que passaram por tratamento radioterápico, sendo 3.249 homens e 883 mulheres, com média de idade de 58,8 anos e média de tempo pós-tratamento igual a 70,19 meses. A prevalência de ageusia foi de 51%, de doença periodontal 48%, de hipossalivação 62% de xerostomia 68% e de ORN 5%. Não foi possível fazer a meta-análise da prevalência de cárie induzida por radiação e de mucosite. O risco de viés nos estudos incluídos foi de moderado a alto. A alta heterogeneidade e presença de fatores de confusão nos estudos, como tratamentos coadjuvantes à radioterapia e comorbidades dos pacientes, são limitações dessa pesquisa. Esta revisão foi registrada no International Prospective Register of Systematic Reviews (PROSPERO): CRD42021261032.
Title in English
Prevalence of oral complications after radiotherapy in head and neck cancer: a systematic review and meta-analysis
Keywords in English
Head and neck neoplasms
Mouth diseases
Radiotherapy
Abstract in English
Patients with head and neck cancer (HNC) undergoing radiotherapy are more susceptible to compromised oral health. This systematic review aims to determine the prevalence of oral complications resulting from radiotherapy in patients with HNC. Searches were performed in the PubMed/MEDLINE, BVS, EMBASE, Livivo, Web of Science, Scopus, Cochrane Library databases to include articles up to October 2021. Manual searches were also performed in the gray literature. We included cross-sectional and cohort observational studies that present data from patients with HNC treated with radiotherapy, regardless of modality and post-treatment time, with prevalence information on ageusia, periodontal disease, hyposalivation, xerostomia, osteoradionecrosis (ORN), caries induced by radiation and oral mucositis, in addition to sociodemographic and clinical data of the patients. For data extraction, only those provided in the articles were considered. Risk of bias analysis of the included studies was performed using the tool proposed by the Joanna Briggs Institute. A narrative synthesis was performed, and the data were meta-analyzed using the random effect model, adopting a significance level of 5%. We included 33 studies (Kappa = 0.89), with a total of 4.166 patients with HNC who underwent radiotherapy treatment, 3.249 men and 883 women, with a mean age of 58,8 years and mean post-treatment time equal to 70,19 months. The prevalence of ageusia was 51%, periodontal disease 48%, hyposalivation 62%, xerostomia 68% and ORN 5%. It was not possible to perform a meta-analysis of the prevalence of radiation-induced caries and mucositis. The risk of bias in the included studies was moderate to high. The high heterogeneity and presence of confounding factors in the studies, such as adjuvant treatments to radiotherapy and patient comorbidities, are limitations of this research. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO): CRD42021261032.
 
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Release Date
2025-06-01
Publishing Date
2023-11-09
 
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