舌癌の小線源治療におけるspacerの臨床

  • 荒木田 郁夫
    東京医科歯科大学歯学部附属病院顎口腔機能治療部
  • 宮原 隆雄
    東京医科歯科大学歯学部障害者歯科学教室
  • 長谷川 裕
    東京医科歯科大学歯学部障害者歯科学教室
  • 谷口 尚
    東京医科歯科大学歯学部附属病院顎口腔機能治療部
  • 大山 喬史
    東京医科歯科大学歯学部附属病院顎口腔機能治療部 東京医科歯科大学歯学部障害者歯科学教室
  • 竹田 正宗
    東京医科歯科大学歯学部歯科放射線学教室
  • 渋谷 均
    東京医科歯科大学医学部放射線医学教室
  • 松本 悟
    東京医科歯科大学医学部放射線医学教室
  • 堀内 淳一
    日本医科大学放射線医学教室

書誌事項

タイトル別名
  • Clinical Consideration on Spacer for Interstitial Brachytherapy of Malignancy of Tongue.

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抄録

In treatment for malignancy of tongue by interstitial brachytherapy, it is very important to prevent the excessive radiation dose to mandible, that is a cause of osteoradionecrosis. For the purpose, we have applied spacers to the patients. We fabricate spacers following prosthodontic methods. Clinically the detarmination of thickness and area of the lingual side of spacer is the most important factor. In taking impression we use custom tray and investigate the space that we can obtain between tongue and mandible. The method is same as the muscle trimming for impression making of full denture, and the area to cover is carefully concidered. In occlusion resistration we increase the vertical dimension for the space of tongue, because after the implantation edama of tongue often appears. In dentulous cases we occasionally use ball type clasps and in edentulous cases we make a chin cap and the appliance for maxilla to retain the spacer at the correct place. The material for spacers is acrilic resin of clear type, because it is very popular to dentists and it is easy to fit to patients. Usually we did not use the shielding materials as lead, because it produce little effect for the radiation quality and we usually take X-ray photographs for computer dosimetry. Following these method we made spacers more than 100 cases from 1987. In almost all cases we can apply the spacer during treatment period of about one week, and could prevent the osteoradionecrosis and reduce the mucositis of mandible. Thus we can fabricate the spacers cirtainly and safely by the clinical method that we have introduced.

収録刊行物

  • 頭頸部腫瘍

    頭頸部腫瘍 17 (2), 166-171, 1991

    日本頭頸部癌学会

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