儿童血液恶性肿瘤化疗的后期口腔不良反应：病例对照研究的系统回顾和荟萃分析。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2024-11-12 DOI:10.1016/j.oraloncology.2024.107103

R. Mishra , A. Kapur , VP. Mathur , D. Sardana

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引用次数: 0

摘要

背景：本系统综述和荟萃分析的目的是对评估化疗治疗儿童血液恶性肿瘤晚期不良反应的病例对照研究进行评估：使用广泛的关键词和MeSH术语检索了五个电子数据库和灰色文献，以寻找符合资格标准的文章。采用纽卡斯尔-渥太华量表进行质量评估。在进行荟萃分析时，采用了德西莫尼安和莱尔德随机效应模型，并使用了（受限最大似然法）REML方法，以计算二元结果的汇总比值比（ORs）和连续结果的标准化平均差（SMD）。利用 GRADEpro® GDT 软件，采用 GRADE 方法对证据的确定性进行综合分析：检索共获得 8052 条记录。在去除重复内容并对标题和摘要进行初步筛选后，有 109 篇文章进行了全文阅读，但只有 5 篇文章被纳入其中。与对照组相比，接受过治疗的患者牙根畸形、小齿畸形、牙齿缺失、牙根发育不全和釉质缺损的总OR值分别为7.68、5.39、3.74、2.00和1.84。龋齿的SMD在各组间也有显著性差异（p= 0.03），SMD为0.27（95% CI：0.03，0.51），表明病例的集合平均DMFT高于对照组：牙根畸形与儿童血液癌症的治疗有关，评估结果具有中等确定性。牙齿发育不全和小牙症与证据的确定性较低，而牙齿发育不全、釉质缺损和龋齿与证据的确定性很低。由于我们的综述中包含的研究数量较少，因此今后需要对更大样本量的研究来验证这些发现。

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Late oral adverse effects of chemotherapy for hematological malignancies in children: A systematic review and meta-analysis of case-control studies

Background

The purpose of the present systematic review and meta-analyses was to appraise the case-control studies that have evaluated late adverse effects of chemotherapy for treating hematological malignancies in pediatric patients.

Methods

Five electronic databases along with grey literature were searched using broad keywords and MeSH terms for the articles that could meet the eligibility criteria. The Newcastle-Ottawa Scale was employed for quality assessment. DerSimonian and Laird random effects model using the (Restricted Maximum Likelihood) REML approach was used for meta-analyses to calculate the pooled Odds Ratios (ORs) for binary outcomes and Standardized Mean Difference (SMD) for continuous outcomes. The GRADE approach was used to synthesize the certainty of evidence utilizing GRADEpro® GDT software.

Results

8,052 records were obtained from the searches. After duplicate removal and initial screening of titles and abstracts, 109 articles were subjected to full-text reading but only 5 could be included. The pooled ORs of having root malformation, microdontia, tooth agenesis, taurodontism, and enamel defects in patients who have undergone treatment were 7.68, 5.39, 3.74, 2.00, and 1.84 compared to controls, respectively. The SMD for dental caries was also significant among the groups (p= 0.03) and indicated an SMD of 0.27 (95% CI: 0.03, 0.51) indicating higher pooled mean DMFT in the cases than controls.

Conclusions

Root malformations are associated with treatment for childhood hematological cancers with a moderate certainty of assessment. Tooth agenesis and microdontia are associated with low certainty of evidence, while taurodontism, enamel defects, and caries were associated with very low certainty of evidence. Future studies on larger sample sizes are needed to validate the findings as the number of studies included in our review was small.

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.