Pei-Hsun Liao1,2, Chi-Hsiang Chu3, Yao-Min Hung4,5,6,7, Pei-Ling Tang8,9,10, Tsu-Jen Kuo11,12,13,14. 1. Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. 2. School of Medicine, National Defense Medical Center, Taipei, Taiwan. 3. Department of Statistics, National Cheng Kung University, Tainan, Taiwan. 4. Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. 5. School of Medicine, National Yang Ming University, Taipei, Taiwan. 6. Yuhing Junior College of Health Care and Management, Kaohsiung, Taiwan. 7. Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan. 8. Research Center of Medical Informatics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. 9. Department of Nursing, Meiho University, Pingtung, Taiwan. 10. College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan. 11. School of Dentistry, Chung Shan Medical University, 110, Sec. 1, Chien-Kuo N. Rd., 40201, Taichung, Taiwan. tsujenkuo@gmail.com. 12. Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan. tsujenkuo@gmail.com. 13. Department of Marine Biotechnology and Resources, National Sun Yat-Sen University, Kaohsiung, Taiwan. tsujenkuo@gmail.com. 14. Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. tsujenkuo@gmail.com.
Abstract
PURPOSE: The association between the tumor subsites of the oral cavity and the risk of osteoradionecrosis of the jaw (ORNJ) remains unclear. We study the correlation between oral cavity tumor subsites and the risk of ORNJ in a nationwide population-based database. METHODS: We enrolled 16,701 adult patients with oral cavity cancers who were treated with radiotherapy between 2000 and 2013. The subsites of the oral tumor, treatments of oral cavity cancers, and the timing of tooth extraction were examined for their association with ORNJ in oral cancer patients. RESULTS: 903 patients (5.40%) developed ORNJ. Of the relevant variables, pre-RT mandible surgery, tooth extraction either before or after RT, and tumor sites were associated with the risk of ORNJ. The adjusted HRs for ORNJ in the mouth floor, gums, retromolar, and buccal cancer were 2.056 (1.490-2.837), 1.909 (1.552-2.349), 1.683 (1.105-2.562), and 1.303 (1.111-1.528), respectively, compared with the risk of tongue cancer. There was no significant difference in the risk of ORNJ between the pre-RT extraction group, the during-RT extraction group, and the post-RT extraction (less than 6 months) group; the post-RT extraction (more than 6 months) group had a significantly higher risk of ORNJ. CONCLUSIONS: This study demonstrated that oral cavity tumor subsite is an independent risk factor of ORNJ after RT. Post-RT extraction (less than 6 months) group did not carry a significantly higher risk of ORNJ compared with pre-RT extraction group or during RT extraction group.
PURPOSE: The association between the tumor subsites of the oral cavity and the risk of osteoradionecrosis of the jaw (ORNJ) remains unclear. We study the correlation between oral cavity tumor subsites and the risk of ORNJ in a nationwide population-based database. METHODS: We enrolled 16,701 adult patients with oral cavity cancers who were treated with radiotherapy between 2000 and 2013. The subsites of the oral tumor, treatments of oral cavity cancers, and the timing of tooth extraction were examined for their association with ORNJ in oral cancerpatients. RESULTS: 903 patients (5.40%) developed ORNJ. Of the relevant variables, pre-RT mandible surgery, tooth extraction either before or after RT, and tumor sites were associated with the risk of ORNJ. The adjusted HRs for ORNJ in the mouth floor, gums, retromolar, and buccal cancer were 2.056 (1.490-2.837), 1.909 (1.552-2.349), 1.683 (1.105-2.562), and 1.303 (1.111-1.528), respectively, compared with the risk of tongue cancer. There was no significant difference in the risk of ORNJ between the pre-RT extraction group, the during-RT extraction group, and the post-RT extraction (less than 6 months) group; the post-RT extraction (more than 6 months) group had a significantly higher risk of ORNJ. CONCLUSIONS: This study demonstrated that oral cavity tumor subsite is an independent risk factor of ORNJ after RT. Post-RT extraction (less than 6 months) group did not carry a significantly higher risk of ORNJ compared with pre-RT extraction group or during RT extraction group.
Authors: Herve Y Sroussi; Joel B Epstein; Rene-Jean Bensadoun; Deborah P Saunders; Rajesh V Lalla; Cesar A Migliorati; Natalie Heaivilin; Zachary S Zumsteg Journal: Cancer Med Date: 2017-10-25 Impact factor: 4.452