Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Häufige urologisch-sexualmedizinische Themen in der Praxis sind das Thema des MMW-Webinars am 5. Juni von 17.30 bis 19 Uhr. Konkret geht es um die Frage, wann bei Harnwegsinfektionen auf Antibiotika verzichtet werden kann, und um ein Update zur Therapie von Libido- und Potenzstörungen des Mannes. Der dritte Vortrag behandelt sexuell übertragbare Krankheiten. Stellen Sie Ihre Fragen an die Experten und sammeln Sie 2 CME-Punkte. Jetzt gleich anmelden!
Erweiterte Suche
Anmelden
nach oben
European Archives of Oto-Rhino-Laryngology
Erschienen in: European Archives of Oto-Rhino-Laryngology 5/2023

07.02.2023 | Head and Neck

Pre-chemoradiotherapy low hemoglobin levels indicate increased osteoradionecrosis risk in locally advanced nasopharyngeal cancer patients

verfasst von: Busra Yilmaz, Efsun Somay, Erkan Topkan, Berrin Pehlivan, Ugur Selek

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 5/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose

We aimed to determine whether pretreatment hemoglobin (Hb) levels can predict the risk of osteoradionecrosis (ORN) in patients receiving concurrent chemoradiotherapy (CCRT) for locally advanced nasopharyngeal carcinoma (LA-NPC).

Methods

ORN cases were identified from the records of LA-NPCs who had oral exams before and after CCRT. All Hb measurements were obtained on the first day of treatment. Receiving operating characteristic curve analysis was used to determine the relationship between Hb levels and ORN rates. The relationship between pretreatment Hb levels and ORN rates served as the primary endpoint, and secondary endpoints included the discovery of additional potential ORN risk factors.

Results

Among the 263 eligible LA-NPCs, we identified 8.7% ORN cases. The ideal cutoff Hb before CCRT was 10.6 g/dL. It was revealed that HPR ≤ 10.6 group had a significantly higher ORN rate (32.5% vs. 1.5% for Hb > 10.6; P < 0.001). The mandibular V59.8 ≥ 36% Gy, pre-CCRT ≥ 4 tooth extractions, the presence of post-CCRT tooth extractions, and the time of post-CCRT tooth extractions > 8 months were the other factors associated with significantly increased ORN rates (P < 0.05 for each).

Conclusion

Low pre-CCRT Hb levels appeared to be independently linked to significantly higher ORN rates. Pretreatment Hb levels may be used to establish preventive measures and predict ORN.
Literatur
1.
Baujat B, Audry H, Bourhis J, Chan AT, Onat H, Chua DT et al (2006) Chemotherapy in locally advanced nasopharyngeal carcinoma: an individual patient data meta-analysis of eight randomized trials and 1753 patients. Int J Radiat Oncol Biol Phys 64:47–56PubMedCrossRef
2.
De Felice F, Musio D, Terenzi V, Valentini V, Cassoni A, Tombolini M et al (2014) Treatment improvement and better patient care: which is the most important one in oral cavity cancer? Radiat Oncol 9:263PubMedPubMedCentralCrossRef
3.
De Felice F, de Vincentiis M, Luzzi V, Magliulo G, Tombolini M, Ruoppolo G et al (2018) Late radiation-associated dysphagia in head and neck cancer patients: evidence, research and management. Oral Oncol 77:125–130PubMedCrossRef
4.
Bras J, de Jonge HK, van Merkesteyn JP (1990) Osteoradionecrosis of the mandible: pathogenesis. Am J Otolaryngol 11:244–250PubMedCrossRef
5.
Ben-David MA, Diamante M, Radawski JD, Vineberg KA, Stroup C, Murdoch-Kinch CA et al (2007) Lack of Osteoradionecrosis of the Mandible after IMRT for head and neck cancer: likely contributions of both dental care and improved dose distribution. Int J Radiat Oncol Biol Phys 68:392–402CrossRef
6.
Beumer J, Harrison R, Sanders B, Kurrasch M (1983) Postradiation dental extractions: a review of the literature and a report of 72 episodes. Head Neck Surg 6:581–586PubMedCrossRef
7.
Jawad H, Hodson NA, Nixon PJ (2015) A review of dental treatment of head and neck cancer patients, before, during and after radiotherapy: part 1. Br Dent J 218:65–68PubMedCrossRef
8.
Jawad H, Hodson NA, Nixon PJ (2015) A review of dental treatment of head and neck cancer patients, before, during and after radiotherapy: part 2. Br Dent J 218:69–74PubMedCrossRef
9.
Pignon JP, le Maître A, Maillard E, Bourhis J, MACH-NC Collaborative Group (2009) Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 92:4–14PubMedCrossRef
10.
Meleca JB, Zhang E, Fritz MA, Ciolek PJ (2021) Overview and emerging trends in the treatment of osteoradionecrosis. Curr Treat Options Oncol 22:115CrossRef
11.
Chrcanovic BR, Albrektsson T, Wennerberg A (2016) Dental implants in irradiated versus nonirradiated patients: a meta-analysis. Head Neck 38:448–441PubMedCrossRef
12.
Buglione M, Cavagnini R, Di Rosario F, Sottocornola L, Maddalo M, Vassalli L et al (2016) Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: Dental pathologies and osteoradionecrosis (Part 1) literature review and consensus statement. Crit Rev Oncol Hematol 97:131–142PubMedCrossRef
13.
Caparrotti F, Huang SH, Lu L, Bratman SV, Ringash J, Bayley A et al (2017) Osteoradionecrosis of the mandible in patients with oropharyngeal carcinoma treated with intensity-modulated radiotherapy. Cancer 123:3691–3700PubMedCrossRef
14.
Oh HK, Chambers MS, Garden AS, Wong PF, Martin JW (2004) Risk of osteoradionecrosis after extraction of impacted third molars in irradiated head and neck cancer patients. J Oral Maxillofac Surg 62:139–144PubMedCrossRef
15.
Costantino PD, Friedman CD, Steinberg MJ (1995) Irradiated bone and its management. Otolaryngol Clin North Am 28:1021–1038PubMedCrossRef
16.
Thorn JJ, Hansen HS, Specht L, Bastholt L (2000) Osteoradionecrosis of the jaws: clinical characteristics and relation to the field of irradiation. J Oral Maxillofac Surg 58:1088–1095PubMedCrossRef
17.
Horiot JC, Bone MC, Ibrahim E, Castro JR (1981) Systematic dental management in head and neck irradiation. Int J Radiat Oncol Biol Phys 7:1025–1029PubMedCrossRef
18.
Marx RE (1983) Osteoradionecrosis: a new concept of its pathophysiology. J Oral Maxillofac Surg 41:283–288PubMedCrossRef
19.
Xu J, Zheng Z, Fang D, Gao R, Liu Y, Fan ZP et al (2012) Early-stage pathogenic sequence of jaw osteoradionecrosis in vivo. J Dent Res 91:702–708PubMedCrossRef
20.
Helvaci MR, Aydogan A, Akkucuk S, Oruc C, Ugur M (2014) Sickle cell diseases and ileus. Int J Clin Exp Med 7:2871–2876PubMedPubMedCentral
21.
Darby IA, Hewitson TD (2016) Hypoxia in tissue repair and fibrosis. Cell Tissue Res 365:553–562PubMedCrossRef
22.
Chrcanovic BR, Reher P, Sousa AA, Harris M (2010) Osteoradionecrosis of the jaws–a current overview–part 1: physiopathology and risk and predisposing factors. Oral Maxillofac Surg 14:3–16PubMedCrossRef
23.
Dhanda J, Pasquier D, Newman L, Shaw R (2016) Current concepts in osteoradionecrosis after head and neck radiotherapy. Clin Oncol (R Coll Radiol) 28:459–466PubMedCrossRef
24.
Castillo-Rodríguez RA, Trejo-Solís C, Cabrera-Cano A, Gómez-Manzo S, Dávila-Borja VM (2022) Hypoxia as a modulator of inflammation and immune response in cancer. Cancers (Basel) 14:2291PubMedCrossRef
25.
Beresford MJ, Burcombe R, Ah-See ML, Stott D, Makris A (2006) Pre-treatment haemoglobin levels and the prediction of response to neoadjuvant chemotherapy in breast cancer. Clin Oncol (R Coll Radiol) 18:453–458PubMedCrossRef
26.
Zheng YY, Wu TT, Chen Y, Hou XG, Yang Y, Zhang JY et al (2020) Platelet-to-hemoglobin ratio as a novel predictor of long-term adverse outcomes in patients after percutaneous coronary intervention: a retrospective cohort study. Eur J Prev Cardiol 27:2216–2219PubMedCrossRef
27.
Mori K, Janisch F, Mostafaei H, Lysenko I, Karakiewicz PI, Enikeev DV et al (2020) Prognostic value of hemoglobin in metastatic hormone-sensitive prostate cancer: a systematic review and meta-analysis. Clin Genitourin Cancer 18(4):e402–e409PubMedCrossRef
28.
Eichbaum MH, Weiss LM, Bruckner T, Schneeweiss A, Sinn HP, Gebauer G et al (2009) Prognostic impact of hemoglobin levels before and during carboplatin/taxane-based chemotherapy in patients with primary invasive epithelial ovarian cancer. Med Sci Monit 15(4):C156-163
29.
Zeng Q, Shen LJ, Li S, Chen L, Guo X, Qian CN, Wu PH (2016) The effects of hemoglobin levels and their interactions with cigarette smoking on survival in nasopharyngeal carcinoma patients. Cancer Med 5(5):816–826PubMedPubMedCentralCrossRef
30.
Montgomery J, Syed MI, Rana I, Singh J, Clark LJ (2010) Hemoglobin monitoring in head and neck cancer patients undergoing radiotherapy. Ann Otol Rhinol Laryngol 119(7):472–475PubMedCrossRef
31.
Hoff CM (2012) Importance of hemoglobin concentration and its modification for the outcome of head and neck cancer patients treated with radiotherapy. Acta Oncol 51(4):419–432PubMedCrossRef
32.
Lee G, Choi S, Kim K, Yun JM, Son JS, Jeong SM et al (2018) Association of hemoglobin concentration and its change with cardiovascular and all-cause mortality. J Am Heart Assoc 7(3):e007723PubMedPubMedCentralCrossRef
33.
Ataga KI, Gordeuk VR, Agodoa I, Colby JA, Gittings K, Allen IE (2020) Low hemoglobin increases risk for cerebrovascular disease, kidney disease, pulmonary vasculopathy, and mortality in sickle cell disease: a systematic literature review and meta-analysis. PLoS ONE 15(4):e0229959PubMedPubMedCentralCrossRef
34.
White SC, Pharoah MJ (2018) Oral radiology-E-book: principles and interpretation. Elsevier, St. Louis, pp 808–832
35.
World Health Organization (1968) Nutritional anemias. Report of a WHO scientific group. World Health Tech Organ Report Series 405
36.
Yilmaz B, Somay E, Selek U, Topkan E (2021) Pretreatment systemic immune-inflammation index predict needs for teeth extractions for locally advanced head and neck cancer patients undergoing concurrent chemoradiotherapy. Ther Clin Risk Manag 17:1113–1121PubMedPubMedCentralCrossRef
37.
Notani K, Yamazaki Y, Kitada H, Sakakibara N, Fukuda H, Omori K et al (2003) Management of mandibular osteoradionecrosis corresponding to the severity of osteoradionecrosis and the method of radiotherapy. Head Neck 25:181–186PubMedCrossRef
38.
Moon DH, Moon SH, Wang K, Weissler MC, Hackman TG, Zanation AM et al (2017) Incidence of, and risk factors for, mandibular osteoradionecrosis in patients with oral cavity and oropharynx cancers. Oral Oncol 72:98–103PubMedCrossRef
39.
Reuther T, Schuster T, Mende U, Kübler A (2003) Osteoradionecrosis of the jaws as a side effect of radiotherapy of head and neck tumour patients–a report of a thirty year retrospective review. Int J Oral Maxillofac Surg 32:289–295PubMedCrossRef
40.
Owosho AA, Tsai CJ, Lee RS, Freymiller H, Kadempour A, Varthis S et al (2017) The prevalence and risk factors associated with osteoradionecrosis of the jaw in oral and oropharyngeal cancer patients treated with intensity-modulated radiation therapy (IMRT): the Memorial Sloan Kettering Cancer Center experience. Oral Oncol 64:44–51PubMedCrossRef
41.
Aarup-Kristensen S, Hansen CR, Forner L, Brink C, Eriksen JG, Johansen J (2019) Osteoradionecrosis of the mandible after radiotherapy for head and neck cancer: risk factors and dose-volume correlations. Acta Oncol 58:1373–1377PubMedCrossRef
42.
Khoo SC, Nabil S, Fauzi AA, Yunus SSM, Ngeow WC, Ramli R (2021) Predictors of osteoradionecrosis following irradiated tooth extraction. Radiat Oncol 16:130PubMedPubMedCentralCrossRef
43.
Wang TH, Liu CJ, Chao TF, Chen TJ, Hu YW (2017) Risk factors for and the role of dental extractions in osteoradionecrosis of the jaws: a national-based cohort study. Head Neck 39:1313–1321PubMedCrossRef
44.
Jiang Y, Zhu X, Qu S (2014) Incidence of osteoradionecrosis in patients who have undergone dental extraction prior to radiotherapy: a systematic review and meta-analysis. J Oral Maxillofac Surg Med Pathol 26:269–275CrossRef
45.
Nabil S, Samman N (2011) Incidence and prevention of osteoradionecrosis after dental extraction in irradiated patients: a systematic review. Int J Oral Maxillofac Surg 40:229–243PubMedCrossRef
46.
Dumoulin S, van Maanen A, Magremanne M (2021) Dental prevention of maxillo-mandibular osteoradionecrosis: a ten-year retrospective study. J Stomatol Oral Maxillofac Surg 122(2):127–134PubMedCrossRef
47.
Kuo TJ, Leung CM, Chang HS, Wu CN, Chen WL, Chen GJ et al (2016) Jaw osteoradionecrosis and dental extraction after head and neck radiotherapy: a nationwide population-based retrospective study in Taiwan. Oral Oncol 56:71–77PubMedCrossRef
48.
Dutheil F, Guillemin F, Biau J, Pham-Dang N, Saroul N, Clavère P, Lapeyre M (2021) Facteurs prédictifs de l’ostéoradionécrose mandibulaire après irradiation des cancers des voies aérodigestives supérieures [Predictive factors for mandibular osteoradionecrosis after irradiation of head and neck cancers]. Cancer Radiother 25(5):484–493PubMedCrossRef
49.
Topkan E, Ekici NY, Ozdemir Y, Besen AA, Yildirim BA, Mertsoylu H et al (2019) Baseline hemoglobin < 110 g/dL has stronger prognostic value than anemia status in nasopharynx cancers treated with chemoradiotherapy. Int J Biol Markers 34(2):139–147PubMedCrossRef
50.
Chapchay K, Weinberger J, Eliashar R, Adler N (2019) Anterior skull base reconstruction following ablative surgery for osteoradionecrosis: case report and review of literature. Ann Otol Rhinol Laryngol 128:1134–1140PubMedCrossRef
51.
Albisinni S, Pretot D, Al Hajj Obeid W, Aoun F, Quackels T, Peltier A et al (2019) The impact of neutrophil-to-lymphocyte, platelet-to-lymphocyte and haemoglobin-to-platelet ratio on localised renal cell carcinoma oncologic outcomes. Prog Urol 29:423–431PubMedCrossRef
52.
Ji C, Su Y, Zhang C, Huang W (2015) Reference intervals for hemoglobin and age- and gender-related trends in the population of southwest China. Clin Lab 61(12):1831–1836PubMed
Metadaten
Titel
Pre-chemoradiotherapy low hemoglobin levels indicate increased osteoradionecrosis risk in locally advanced nasopharyngeal cancer patients
verfasst von
Busra Yilmaz
Efsun Somay
Erkan Topkan
Berrin Pehlivan
Ugur Selek
Publikationsdatum
07.02.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 5/2023
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-023-07864-7

Weitere Artikel der Ausgabe 5/2023

European Archives of Oto-Rhino-Laryngology 5/2023 Zur Ausgabe

Otology

Age- and gender-specific normative data on computerized dynamic posturography in a cohort of Danish adults

Otology

Is there progression of endolymphatic hydrops in Ménière’s disease? Longitudinal magnetic resonance study

Rhinology

Does a closed reduction improve aesthetical and functional outcome after nasal fracture?

Head and Neck

FraMaDySc: dysphagia screening for patients after surgery for head and neck cancer

Head and Neck

Ultrasonographic and cytological characterization of ultrasound-guided fine-needle aspiration cytology of cervical lymph nodes for false-negative and false-positive diagnosis

Head and Neck

Impact of drainless neck dissection on surgical outcome: a matched case–control study

Neu im Fachgebiet HNO

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

16.05.2024 Pädiatrische Allergologie Nachrichten

Die große Mehrheit der vermeintlichen Penicillinallergien sind keine. Da das „Etikett“ Betalaktam-Allergie oft schon in der Kindheit erworben wird, kann ein frühzeitiges Delabeling lebenslange Vorteile bringen. Ein Team von Pädiaterinnen und Pädiatern aus Kanada stellt vor, wie sie dabei vorgehen.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Eingreifen von Umstehenden rettet vor Erstickungstod

15.05.2024 Fremdkörperaspiration Nachrichten

Wer sich an einem Essensrest verschluckt und um Luft ringt, benötigt vor allem rasche Hilfe. Dass Umstehende nur in jedem zweiten Erstickungsnotfall bereit waren, diese zu leisten, ist das ernüchternde Ergebnis einer Beobachtungsstudie aus Japan. Doch es gibt auch eine gute Nachricht.

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen
Bildnachweise