PURPOSE: The incidence of osteonecrosis of the mandibula (ON) after irradiation using modern three-dimensional planning as well as hyperfractionation or moderately accelerated irradiation has been evaluated and compared with the incidence of the preceding period. PATIENTS AND METHODS: The records of 268 head and neck cancer patients irradiated between January 1, 1980 and December 31, 1998 with a dose to the mandibula of at least 60 Gy were retrospectively analyzed. All patients had CT-based treatment planning, computerized dose calculation with isodose charts also in several off-axis planes, and regular verification films. RESULTS: The long-term cumulative incidence of ON needing mandibular resection was as follows: after conventional fractionation 6.2% (between 60 and 66.6 Gy target dose) or 20.1% (between > 66.6 and 72 Gy); after hyperfractionated irradiation with a target dose between 72 and 78.8 Gy 6.6%; after concomitant boost irradiation according to the MDA/Houston regime with a dose between 63.9 and 70.5 Gy: no case; after 6 x 2 Gy/week or 7 x 1.8 Gy/week and a total target dose between 66 and 72 Gy approximately 17% or higher (small patient number). CONCLUSION: Comparison of the incidence of ON during the period between 1980 and 1990 with the following period between 1990 and 1998 shows a decrease in risk to a value of approximately 5% using modern three-dimensional techniques as well as hyperfractionation or moderately accelerated fractionation.
PURPOSE: The incidence of osteonecrosis of the mandibula (ON) after irradiation using modern three-dimensional planning as well as hyperfractionation or moderately accelerated irradiation has been evaluated and compared with the incidence of the preceding period. PATIENTS AND METHODS: The records of 268 head and neck cancerpatients irradiated between January 1, 1980 and December 31, 1998 with a dose to the mandibula of at least 60 Gy were retrospectively analyzed. All patients had CT-based treatment planning, computerized dose calculation with isodose charts also in several off-axis planes, and regular verification films. RESULTS: The long-term cumulative incidence of ON needing mandibular resection was as follows: after conventional fractionation 6.2% (between 60 and 66.6 Gy target dose) or 20.1% (between > 66.6 and 72 Gy); after hyperfractionated irradiation with a target dose between 72 and 78.8 Gy 6.6%; after concomitant boost irradiation according to the MDA/Houston regime with a dose between 63.9 and 70.5 Gy: no case; after 6 x 2 Gy/week or 7 x 1.8 Gy/week and a total target dose between 66 and 72 Gy approximately 17% or higher (small patient number). CONCLUSION: Comparison of the incidence of ON during the period between 1980 and 1990 with the following period between 1990 and 1998 shows a decrease in risk to a value of approximately 5% using modern three-dimensional techniques as well as hyperfractionation or moderately accelerated fractionation.
Authors: Salvatore Ruggiero; Julie Gralow; Robert E Marx; Ana O Hoff; Mark M Schubert; Joseph M Huryn; Bela Toth; Kathryn Damato; Vicente Valero Journal: J Oncol Pract Date: 2006-01 Impact factor: 3.840
Authors: Adepitan A Owosho; SaeHee K Yom; Zhiqiang Han; Kevin Sine; Nancy Y Lee; Joseph M Huryn; Cherry L Estilo Journal: Oral Surg Oral Med Oral Pathol Oral Radiol Date: 2016-07-19
Authors: Adepitan A Owosho; C Jillian Tsai; Ryan S Lee; Haley Freymiller; Arvin Kadempour; Spyridon Varthis; Adi Z Sax; Evan B Rosen; SaeHee K Yom; Joseph Randazzo; Esther Drill; Elyn Riedel; Snehal Patel; Nancy Y Lee; Joseph M Huryn; Cherry L Estilo Journal: Oral Oncol Date: 2016-12-03 Impact factor: 5.337