Jan-Dirk Raguse1, Jaber Hossamo1, Ingeborg Tinhofer2, Bodo Hoffmeister1, Volker Budach2, Basil Jamil3, Korinna Jöhrens4, Nadine Thieme5, Christian Doll1, Susanne Nahles1, Stefan T Hartwig1, Carmen Stromberger6. 1. Department of Oral and Maxillofacial Surgery, Charité University Medicine, Berlin, Germany. 2. Department of Radiation Oncology and Radiotherapy, Charité University Medicine, Berlin, Germany. 3. Department of Radiation Oncology and Radiotherapy, Charité University Medicine, Berlin, Germany; Praxis für Strahlentherapie, Klinikum Frankfurt Oder, Frankfurt, Germany. 4. Department of Pathology, Charité University Medicine, Berlin, Germany. 5. Department of Radiology, Charité University Medicine, Berlin, Germany. 6. Department of Radiation Oncology and Radiotherapy, Charité University Medicine, Berlin, Germany. Electronic address: Carmen.stromberger@charite.de.
Abstract
OBJECTIVE: The purpose of this study was to evaluate risk factors for and the incidence of osteoradionecrosis (ORN) of the jaw in patients with head and neck cancer. STUDY DESIGN: This study was a retrospective analysis of the risk for ORN and outcome for 149 of 540 patients with head and neck cancer of the oral cavity (65%), oropharynx (26%), or other head and neck sites (9%) treated with radiotherapy between 2004 and 2009. ORN was graded according to Late Effects of Normal Tissues/Somatic Objective Management Analytic Scale (LENT/SOMA) criteria. RESULTS: Within a median follow-up of 41 months (95% confidence interval: 27.4-54.6), 38 patients (25.5%) had developed ORN, 37 patients (25%) had a local recurrence, and 53 patients (36%) had died. The median time to diagnosis of ORN was 14.5 months (range: 3-80), and 79% were diagnosed within 2 years of RT. Eleven of these patients had undergone previous mandibular surgery. Univariate significant risk factors for ORN were any comorbidity, poor oral hygiene, pre-radiotherapy osteotomy, close tumor-to-bone proximity, post-radiotherapy dentoalveolar surgery (DAS), DAS without sufficient wound closure, alcohol consumption, and denture pressure sores. In multivariate analysis, comorbidities, pre-radiotherapy mandibular surgery, poor oral hygiene, and insufficient DAS remained significant. CONCLUSIONS: Reducing the risk of ORN calls for maintaining optimal oral hygiene, ensuring good denture fit, receiving proper training in DAS, and helping patients to stop drinking and smoking.
OBJECTIVE: The purpose of this study was to evaluate risk factors for and the incidence of osteoradionecrosis (ORN) of the jaw in patients with head and neck cancer. STUDY DESIGN: This study was a retrospective analysis of the risk for ORN and outcome for 149 of 540 patients with head and neck cancer of the oral cavity (65%), oropharynx (26%), or other head and neck sites (9%) treated with radiotherapy between 2004 and 2009. ORN was graded according to Late Effects of Normal Tissues/Somatic Objective Management Analytic Scale (LENT/SOMA) criteria. RESULTS: Within a median follow-up of 41 months (95% confidence interval: 27.4-54.6), 38 patients (25.5%) had developed ORN, 37 patients (25%) had a local recurrence, and 53 patients (36%) had died. The median time to diagnosis of ORN was 14.5 months (range: 3-80), and 79% were diagnosed within 2 years of RT. Eleven of these patients had undergone previous mandibular surgery. Univariate significant risk factors for ORN were any comorbidity, poor oral hygiene, pre-radiotherapy osteotomy, close tumor-to-bone proximity, post-radiotherapy dentoalveolar surgery (DAS), DAS without sufficient wound closure, alcohol consumption, and denture pressure sores. In multivariate analysis, comorbidities, pre-radiotherapy mandibular surgery, poor oral hygiene, and insufficient DAS remained significant. CONCLUSIONS: Reducing the risk of ORN calls for maintaining optimal oral hygiene, ensuring good denture fit, receiving proper training in DAS, and helping patients to stop drinking and smoking.
Authors: Nathaniel S Treister; Michael T Brennan; Thomas P Sollecito; Brian L Schmidt; Lauren L Patton; Rebecca Mitchell; Robert I Haddad; Roy B Tishler; Alexander Lin; Ryann Shadick; James S Hodges; Rajesh V Lalla Journal: Cancer Date: 2021-10-19 Impact factor: 6.860
Authors: Suad Aljohani; Riham Fliefel; Teresa Franziska Brunner; Aristeidis Chronopoulos; Nada Binmadi; Sven Otto Journal: J Int Med Res Date: 2022-06 Impact factor: 1.573
Authors: R V Lalla; N Treister; T Sollecito; B Schmidt; L L Patton; K Mohammadi; J S Hodges; M T Brennan Journal: Oral Dis Date: 2017-08-03 Impact factor: 3.511