Comparison of osteoradionecrosis of the jaw after superselective intra-arterial chemoradiotherapy versus conventional concurrent chemoradiotherapy of oral cancer.

PURPOSE: The purpose of the present study was to compare the incidence of osteoradionecrosis between superselective intra-arterial chemoradiotherapy and intravenous chemoradiotherapy and to verify the risk factors for osteoradionecrosis. MATERIALS AND METHODS: Of the 79 patients with oral cancer, 40 were treated with intra-venous chemoradiotherapy and 39 were treated with superselective intra-arterial chemoradiotherapy. The incidence of, and risk factors for, osteoradionecrosis were evaluated using statistical analysis. RESULTS: Of the 79 patients, 4 (10%) of 40 in the intravenous chemoradiotherapy and 7 (17.9%) of 39 in the superselective intra-arterial chemoradiotherapy group developed osteoradionecrosis of the jaw. No significant difference was found between the 2 groups. Although the chemoradiotherapy methods, anatomic tumor location, smoking behavior, alcohol consumption, condition of teeth, teeth extraction before radiation, and progression of dental caries were considered predisposing factors for the occurrence of osteoradionecrosis, only progressive dental caries resulted in a significant difference for osteoradionecrosis. CONCLUSIONS: The present study is the first report comparing the incidence of osteoradionecrosis between superselective intra-arterial chemoradiotherapy and intravenous chemoradiotherapy. The administration methods of anticancer drugs were not related to the incidence of osteoradionecrosis in our study. From our study, dental caries is the most important risk factor for osteoradionecrosis; therefore, a radiation caries prevention program is crucial to control osteoradionecrosis.