The incidence of osteoradionecrosis of the jaws in oral cavity cancer patients treated with intensity-modulated radiotherapy: a systematic review and meta-analysis.
Oral Surg Oral Med Oral Pathol Oral Radiol
; 138(1): 66-78, 2024 07.
Article
em En
| MEDLINE
| ID: mdl-38772792
ABSTRACT
OBJECTIVE:
A systematic review with meta-analysis was conducted to define the incidence of osteoradionecrosis (ORN) in patients with oral cavity cancer (OCC) treated with intensity-modulated radiotherapy (IMRT), and to identify the risk factors influencing its development. STUDYDESIGN:
Six databases were searched systematically. A meta-analysis was performed to determine overall, spontaneous, and dental extraction-attributed incidences of ORN. The Grading of Recommendations Assessment, Development, and Evaluation tool evaluated evidence certainty.RESULTS:
Out of 11 eligible studies, 6 underwent meta-analysis for the overall aggregated ORN incidence in OCC patients receiving IMRT, resulting in an incidence rate of 8% (95% CI 6%-11%). Regarding development reasons, 2 studies were assessed, revealing an incidence of 36% (95% CI 1%-98%) for spontaneous ORN, and 17% (95% CI 5%-44%) ensued from dental extraction exclusively pre-RT. All rates had very low certainty of evidence. Factors significantly correlated with ORN development included postoperative RT use (78%), employment of therapeutic doses above 50 Gy, and mandibular involvement (80.5%).CONCLUSION:
The findings suggest that IMRT alone is not sufficient to decrease ORN rates in OCC patients, underscoring the importance of precisely identifying the involved risk factors. However, further detailed primary studies will be necessary.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Osteorradionecrose
/
Neoplasias Bucais
/
Radioterapia de Intensidade Modulada
Limite:
Humans
Idioma:
En
Revista:
Oral Surg Oral Med Oral Pathol Oral Radiol
Ano de publicação:
2024
Tipo de documento:
Article