Onkolojik tedavi gören çocuklarda ağız ve diş sağlığı

Günümüzde kanser hastalarının sayısı ve buna bağlı olarak kanserden ölüm oranı gittikçe artmaktadır. Bilimin ve teknolojinin ilerlemesiyle kanser tedavisinde ilerleme sağlanmış ve yeni kemoterapi ajanları ve radyoterapi teknikleri kullanıma girmiştir. Bu yeni buluşlar, hastalığın yayılmasının önlenmesi ve tedavisinde etkin olarak kullanılmalarına rağmen, halen sistemik ve lokal bir takım ciddi komplikasyonlara ve yan etkilere sebep olmaktadır. Kanser hastalarında mevcut hastalığa veya tedaviye bağlı olarak yaşam kalitesini düşüren sonuçların görülmesi bu dönemde hasta bakımı ve takibini ön plana çıkarmaktadır. Çocuklarda görülen kanser türleri ve hastalığın prognozu yetişkinlerden farklıdır. Onkolojik tedavi gören çocuklarda sağlık sorunlarının ve tedavi komplikasyonlarının yetişkinlere göre daha ağır olduğu bilinmektedir. Kemoterapinin yan etkileri daha kısa süreli ve geçicidir; ancak, radyoterapi daha uzun süreli ve kalıcı yan etkilere sahiptir. Bu yan etkilerden başlıcaları; mukozitis, ağız kuruluğu, radyasyon çürükleri, fırsatçı enfeksiyonlar ve osteoradyonekrozdur. Primer kanser odağı ağız dışında olsa bile onkolojik tedavinin sistemik yan etkileri orofasiyal bölgede komplikasyonlara yol açarak çocuğun yaşam kalitesini düşüren sağlık sorunlarına sebep olabilir. Çocuk hastalarda kemoterapi ve radyoterapinin orofasiyal yapılar üzerine olumsuz etkilerinin azaltılması veya tedavisinde pedodontistlere önemli görevler düşmektedir. Bu nedenle onkolojik tedavi bir takım çalışması şeklinde planlanmalı ve pedodontistler tedavi başlamadan önce, tedavi sürecinde ve tedavi bittikten sonra ağız ve diş sağlığının sürdürülmesinde belirleyici rol oynamalıdırlar. Bu derlemenin amacı, onkolojik tedavi gören çocuk hastalarda oral komplikasyonların tartışılması ve bu komplikasyonların önlenmesi ve tedavisi için alternatif yöntemlerin ele alınmasıdır.

Anahtar Kelimeler:

Ağız Sağlığı, Çocuk, Kemoterapi, Onkolojik Tedavi, Radyoterapi

Oral and dental health in children receiving oncological therapy

Today, the number of cancer patients and consequently the death rate from cancer is gradually increasing. With the progress of science and technology, improvement has been achieved in cancer treatment and new chemotherapy agents and radiotherapy techniques have been introduced. Despite the use of these new discoveries in the treatment and in the prevention of the spread of the disease, they still cause systemic and local complications as well as a number of serious complications. Decrease in quality of life in cancer patients due to existing disease or treatment underline the importance of care and follow-up during this period. The types and prognosis of cancer differ in children and adults. Even if primary cancer focus is outside the mouth, systemic side effects of the oncological treatment may lead to complications and can cause health problems decreasing the life quality of child. Health problems and complications in children receiving oncological treatment are known to be more severe than that of adults. Chemotherapy has short-term and transient side effects, whereas radiotherapy has more long-term and permanent side effects. The main side effects are: mucositis, xerestomia, radiation caries, opportunistic infections and osteoradionecrosis. Pediatric dentists undertake an important role for decreasing side effects of chemotherapy and radiotherapy in orofacial structures. Therefore, oncological treatment should be planned as a team work, and before, during and after treatment, pediatric dentists should play a decisive role in maintaining the oral and dental health. The aim of this review is to discuss oral complications in children receiving oncological treatment and to highlight alternative methods for treatment.

Keywords:

Chemotherapy, Child, Oncological Therapy, Oral Health, Radiotherapy,

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