Factors predictive of severity of osteoradionecrosis of the mandible

✍ Scribed by Shamit Chopra; Dev Kamdar; Ozlem E. Tulunay Ugur; George Chen; Brian Peshek; Mark Marunick; Harold Kim; Ho-Sheng Lin; John Jacobs

• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 94 KB
• Volume: 33
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.21654

✦ Synopsis

Abstract

Background

An analysis of risk factors predictive of severe mandibular osteoradionecrosis (ORN) is needed to aid prophylaxis and management of this condition.

Methods

We retrospectively analyzed 46 patients diagnosed between June 2002 and March 2009: 93% had mandibular ORN, which was staged 0 to III (Store and Boysen). Patient, tumor, treatment‐related, and other variables were analyzed for association with mandibular ORN severity.

Results

Oral or oropharyngeal tumors comprised 85% of our primary tumors, 80% were stage IV, and 91% were squamous cell carcinomas. Most patients (87%) received 3‐dimensional (3D) conformal radiation therapy (RT), with 60 Gray (Gy) median dose; 28% and 72% received primary and adjuvant RT, respectively; 78% received chemotherapy, mostly concurrent (97%) and platinum‐based (96%). Median time to development of ORN was 7.5 months. White ethnicity and secondary infection correlated significantly with stage III mandibular ORN (p = .038, p = .0007, respectively). Advanced age, stage IV, RT dose, post‐RT, and lack of pre‐RT dental extractions appeared predictive of severe mandibular ORN.

Conclusions

The above‐cited factors are predictive of severity and can potentially guide prophylaxis and management. © 2011 Wiley Periodicals, Inc. Head Neck, 2011.