Ti-Hao Wang1,2, Chia-Jen Liu3,4,5, Tze-Fan Chao5,6,7, Tzeng-Ji Chen4,5,8, Yu-Wen Hu1,4,5. 1. Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan. 2. Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan. 3. Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 4. Institute of Public Health, National Yang-Ming University, Taipei, Taiwan. 5. School of Medicine, National Yang-Ming University, Taipei, Taiwan. 6. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 7. Institute of Clinical Medicine and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan. 8. Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Abstract
BACKGROUND: The purpose of this study was to investigate the risk factors, especially the use of certain drugs and the dental procedures, for osteoradionecrosis of the jaw (ORNJ) in patients with head and neck cancer undergoing irradiation as their primary treatment. METHODS: The cohort was composed of 23,527 patients with head and neck cancer. Cox proportional hazard models were used for risk factors analysis. RESULTS: The overall incidence of ORNJ is 3.93 per 100 person-years. Buccal cancer carried the highest ORNJ risk. The use of steroids had a protective effect. Preradiotherapy extraction posed no excess risk, whereas postradiotherapy extraction was associated with gradually increased risk of ORNJ over time that peaked at 4 to 5 years. CONCLUSION: ORNJ warrants life-long attention for head and neck cancer survivors. The present study strongly confirms the role of preirradiation dental extractions. Meanwhile, efforts should be made to prevent posttreatment extractions, especially in the first posttreatment 4 years.
BACKGROUND: The purpose of this study was to investigate the risk factors, especially the use of certain drugs and the dental procedures, for osteoradionecrosis of the jaw (ORNJ) in patients with head and neck cancer undergoing irradiation as their primary treatment. METHODS: The cohort was composed of 23,527 patients with head and neck cancer. Cox proportional hazard models were used for risk factors analysis. RESULTS: The overall incidence of ORNJ is 3.93 per 100 person-years. Buccal cancer carried the highest ORNJ risk. The use of steroids had a protective effect. Preradiotherapy extraction posed no excess risk, whereas postradiotherapy extraction was associated with gradually increased risk of ORNJ over time that peaked at 4 to 5 years. CONCLUSION: ORNJ warrants life-long attention for head and neck cancer survivors. The present study strongly confirms the role of preirradiation dental extractions. Meanwhile, efforts should be made to prevent posttreatment extractions, especially in the first posttreatment 4 years.
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