Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Oral and maxillofacial surgeryOsteoradionecrosis following treatment for head and neck cancer and the effect of radiotherapy dosimetry: the Guy's and St Thomas' Head and Neck Cancer Unit experience
Section snippets
Patient population
Data of patients with ORN treated for primary HNC between January 2009 and April 2014 were retrospectively reviewed. All cases were discussed in a meeting of a multidisciplinary team, including clinical oncologists, surgeons, dentists, radiologists, and pathologists. For all cases demographic data (including gender, age, smoking, alcohol, performance status), primary tumor parameters (i.e., localization, tumor stage, treatment modality, toxicity) and dental assessment documentation (time and
Baseline characteristics
Between January 2009 and April 2014, 653 consecutive patients with histologically proven HNC received radical RT. During this period, 36 patients were treated for ORN, with an overall incidence of 5.5%. Baseline patient and primary tumor characteristics are shown in Table II.
The vast majority of patients were male (n = 23; 64%) smokers (n = 27; 75%). At diagnosis, the primary tumor was mostly located in the oropharynx (n = 16; 44%), and the majority (n = 32; 89%) had locally advanced disease
Discussion
This is a single-institution retrospective analysis of patients diagnosed and treated for ORN following RT for HNC. The overall incidence of ORN in our patient population who received RT during this period was 5.5%. This relative low incidence might relate to the high proportion (89%) of patients treated with IMRT. Although limited data are available to assess the incidence in relation to RT technique and the influence of IMRT remains controversial, the prevalence of ORN in patients treated
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2023, Saudi Dental JournalEarly detection of mandible osteoradionecrosis risk in a high comorbidity veteran population
2023, American Journal of Otolaryngology - Head and Neck Medicine and SurgeryCitation Excerpt :Imaging studies conducted by the Joint Head and Neck Radiotherapy-MRI Development Cooperative at the University of Texas MD Anderson Cancer Center and collaborating institutions strongly support a hypothesis of radiation-altered bone vascularity as a critical contributor to ORN development [5–7]. Reported ORN rates range from 0 to 16 % [8–10]. This discrepancy in disease incidence may be partially explained by the evolution of radiation delivery from three dimensional conformal strategies to intensity-modulated radiation therapy (IMRT), which can deliver comparable doses to tumors with lower radiation delivery to surrounding tissues [11].
Osteoradionecrosis rate in oropharynx cancer treated with dose volume histogram based constraints
2022, Radiotherapy and OncologyCitation Excerpt :Similar analyses have also found V50Gy to be significantly associated with ORN and suggest that a goal of minimizing V50Gy in plan optimization may reduce ORN incidence [10,22,23]. Volume of the mandible receiving 60 Gy has also shown potential utility as a constraint [10,18,24]. These approaches established the importance of intermediate-dose mandibular constraints, which led to the introduction of V44Gy and V58Gy as important dose thresholds.
Is Dose Volume a Better Predictor of Osteoradionecrosis Risk Than Total Dose for Patients Who Have Received Head and Neck Radiation?
2022, Journal of Oral and Maxillofacial SurgeryPredictive factors for mandibular osteoradionecrosis after irradiation of head and neck cancers
2021, Cancer/RadiotherapieOsteoradionecrosis: Exposing the Evidence Not the Bone
2021, International Journal of Radiation Oncology Biology Physics