Stem Cell Reviews and Reports ( IF 4.5 ) Pub Date : 2020-09-01 , DOI: 10.1007/s12015-020-10034-5 Anders Kierkegaard Gundestrup 1 , Charlotte Duch Lynggaard 1 , Lone Forner 2 , Terhi J Heino 3 , Kathrine Kronberg Jakobsen 1 , Anne Fischer-Nielsen 4 , Christian Grønhøj 1 , Christian von Buchwald 1
|
Background
Osteoradionecrosis (ORN) of the mandible is a severe complication of radiotherapy for head and neck cancer and is arduously difficult to manage. Current treatment options carry risks with some patients remaining incurable. Mesenchymal stromal/stem cell (MSC) therapy has shown promising results supporting osteogenesis and regeneration of radiotherapy-damaged tissues. The aim of this study was to systematically review the literature on the safety and efficacy of MSCs in treating ORN.
Methods
A systematic search was performed on MEDLINE, Embase, Cochranes Library online databases, and clinicaltrials.gov to identify preclinical and clinical studies examining the effect of MSCs on osseous healing of ORN. The preclinical studies were assessed according to the SYRCLEs guidelines and risk of bias tool.
Results
Six studies (n = 142) from 5 countries were eligible for analysis. Of these four were preclinical studies and two clinical case studies. Preclinical studies found MSC treatment to be safe, demonstrating bone restorative effects and improved soft tissue regeneration. In the clinical cases, healing of bone and soft tissue was reported with no serious adverse events.
Conclusion
The evidence from the included studies suggests that MSCs may have beneficial regenerative effects on the healing of ORN. None of the studies reported adverse events with the use of MSCs. More carefully controlled studies with well-identified cells are however needed to demonstrate the efficacy of MSCs in a clinical setting.
Graphical abstract
中文翻译：
下颌骨放射性骨坏死的间充质干细胞治疗：临床前和人体研究的系统评价。
背景
下颌骨放射性骨坏死 (ORN) 是头颈癌放疗的严重并发症，难以控制。目前的治疗选择存在风险，一些患者仍然无法治愈。间充质基质/干细胞 (MSC) 治疗显示出有希望的结果，支持放疗损伤组织的成骨和再生。本研究的目的是系统地回顾有关 MSCs 治疗 ORN 的安全性和有效性的文献。
方法
在 MEDLINE、Embase、Cochranes 图书馆在线数据库和 Clinicaltrials.gov 上进行了系统搜索，以确定检查 MSCs 对 ORN 骨愈合影响的临床前和临床研究。根据 SYRCLEs 指南和偏倚风险工具对临床前研究进行评估。
结果
来自 5 个国家的六项研究 ( n = 142) 符合分析条件。这四个是临床前研究和两个临床案例研究。临床前研究发现 MSC 治疗是安全的，显示出骨修复效果和改善软组织再生。在临床病例中，据报道骨和软组织的愈合没有严重的不良事件。
结论
纳入研究的证据表明，MSCs 可能对 ORN 的愈合具有有益的再生作用。没有一项研究报告了使用 MSC 的不良事件。然而，需要对识别良好的细胞进行更仔细的对照研究，以证明 MSCs 在临床环境中的功效。
图形概要
京公网安备 11010802027423号