Yi-Fang Huang1,2, Chih-Hsin Muo3, Chun-Hao Tsai4,5, Shih-Ping Liu6,7,8, Chung-Ta Chang9,10. 1. Department of General Dentistry, Chang Gung Memorial Hospital, Linkou, 33305, Taiwan. 2. School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 11031, Taiwan. 3. Management Office for Health Data, China Medical University Hospital, Taichung, 40402, Taiwan. 4. Department of Orthopedics, China Medical University Hospital, Taichung, 40402, Taiwan. 5. Graduate Institute of Clinical Medicine, China Medical University, Taichung, 40402, Taiwan. 6. Graduate Institute of Basic Medical Science, China Medical University, No. 91, Hsueh-Shih Road, Taichung City, 40402, Taiwan. spliu@mail.cmuh.org.tw. 7. Center for Neuropsychiatry, China Medical University Hospital, Taichung, 40402, Taiwan. spliu@mail.cmuh.org.tw. 8. Department of Social Work, Asia University, Taichung, 41354, Taiwan. spliu@mail.cmuh.org.tw. 9. School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 11031, Taiwan. chungta2001@gmail.com. 10. Department of Emergency Medicine, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist, New Taipei City, 22056, Taiwan. chungta2001@gmail.com.
Abstract
OBJECTIVES: Determine the association between sialadenitis and osteonecrosis of the jaw (ONJ) in head and neck cancer (HNC) patients with varying severity of sialadenitis, treatment modalities, and cancer locations. MATERIALS AND METHODS: A total of 40,168 HNC patients, including 1907 ONJ subjects and 7559 matched comparisons, were enrolled from a Longitudinal Health Insurance Database for Catastrophic Illness Patients of Taiwan between 2000 and 2006. The association with sialadenitis and ONJ was estimated by logic regression and presented as the odds ratio (OR) and 95% confidence intervals (CIs). RESULTS: The occurrence of sialadenitis increased the risk of ONJ by 2.55-fold in HNC patients (95% CI = 2.20-2.95). The ONJ incidence was proportion to sialadenitis severity (OR = 2.53 to 4.43). Irradiated HNC patients had a higher tendency to develop jaw necrosis (osteoradionecrosis, ORN) (OR = 5.05, 95% CI = 4.39-5.80). When combined with irradiation exposure, sialadenitis significantly induced the occurrence of ORN (OR = 8.94, 95% CI = 7.40-10.8), especially in oral cancer patients (OR = 15.9 95% CI = 12.5-20.3). The risk of ONJ increased with radiotherapy dosage and duration, except for nasopharyngeal cancer (NPC) patients. CONCLUSIONS: There was a close association between sialadenitis and ONJ in the HNC population. The severity of sialadenitis was positive correlated to ONJ risk. Radiotherapy combined with sialadenitis significantly raised ORN incidence in HNC patients except for NPC patients. CLINICAL RELEVANCE: HNC patients complained that xerostomia from sialadenitis might increase the risk to develop ONJ, especially among those who received radiotherapy.
OBJECTIVES: Determine the association between sialadenitis and osteonecrosis of the jaw (ONJ) in head and neck cancer (HNC) patients with varying severity of sialadenitis, treatment modalities, and cancer locations. MATERIALS AND METHODS: A total of 40,168 HNC patients, including 1907 ONJ subjects and 7559 matched comparisons, were enrolled from a Longitudinal Health Insurance Database for Catastrophic Illness Patients of Taiwan between 2000 and 2006. The association with sialadenitis and ONJ was estimated by logic regression and presented as the odds ratio (OR) and 95% confidence intervals (CIs). RESULTS: The occurrence of sialadenitis increased the risk of ONJ by 2.55-fold in HNC patients (95% CI = 2.20-2.95). The ONJ incidence was proportion to sialadenitis severity (OR = 2.53 to 4.43). Irradiated HNC patients had a higher tendency to develop jaw necrosis (osteoradionecrosis, ORN) (OR = 5.05, 95% CI = 4.39-5.80). When combined with irradiation exposure, sialadenitis significantly induced the occurrence of ORN (OR = 8.94, 95% CI = 7.40-10.8), especially in oral cancerpatients (OR = 15.9 95% CI = 12.5-20.3). The risk of ONJ increased with radiotherapy dosage and duration, except for nasopharyngeal cancer (NPC) patients. CONCLUSIONS: There was a close association between sialadenitis and ONJ in the HNC population. The severity of sialadenitis was positive correlated to ONJ risk. Radiotherapy combined with sialadenitis significantly raised ORN incidence in HNC patients except for NPCpatients. CLINICAL RELEVANCE: HNC patients complained that xerostomia from sialadenitis might increase the risk to develop ONJ, especially among those who received radiotherapy.
Entities:
Keywords:
Head and neck cancer; Osteonecrosis of the jaw; Osteoradionecrosis; Population-based; Radiotherapy; Sialadenitis
Authors: H Mawardi; G Giro; M Kajiya; K Ohta; S Almazrooa; E Alshwaimi; S-B Woo; I Nishimura; T Kawai Journal: J Dent Res Date: 2011-09-15 Impact factor: 6.116
Authors: Aliya A Khan; Archie Morrison; David A Hanley; Dieter Felsenberg; Laurie K McCauley; Felice O'Ryan; Ian R Reid; Salvatore L Ruggiero; Akira Taguchi; Sotirios Tetradis; Nelson B Watts; Maria Luisa Brandi; Edmund Peters; Teresa Guise; Richard Eastell; Angela M Cheung; Suzanne N Morin; Basel Masri; Cyrus Cooper; Sarah L Morgan; Barbara Obermayer-Pietsch; Bente L Langdahl; Rana Al Dabagh; K Shawn Davison; David L Kendler; George K Sándor; Robert G Josse; Mohit Bhandari; Mohamed El Rabbany; Dominique D Pierroz; Riad Sulimani; Deborah P Saunders; Jacques P Brown; Juliet Compston Journal: J Bone Miner Res Date: 2015-01 Impact factor: 6.741