Risk profile for osteoradionecrosis of the mandible in the IMRT era.
Strahlenther Onkol
; 192(1): 32-9, 2016 Jan.
Article
em En
| MEDLINE
| ID: mdl-26265308
ABSTRACT
BACKGROUND:
The risk for osteoradionecrosis (ORN) of the mandible is positively related to bone volume exposed to > ~ 60 Gy. We hypothesized that in combined treatment, surgery may also be a risk factor. PATIENTS ANDMETHODS:
The impact of mandibular surgery on ORN in locally disease-free IMRT cohorts was retrospectively analyzed.RESULTS:
Between October 2002 and October 2013, 531 of 715 patients with oral cavity cancer (OCC), mesopharyngeal cancer (MC), or salivary gland tumor were treated with the mandible bone exposed to ~ > 60 Gy (mean follow-up, 38 months; 7-143 months). Of the 531 patients, 36 developed ORN (7 %; 1.5 % with grade 3-4). The ORN rate in definitive IMRT MC (16/227) and in postoperative IMRT OCC patients with no mandibular surgery (3/46) was 7 % each; in OCC patients with mandibular surgery the rate was 29 % (15/60, p = 0.002). Marginal or periosteal bone resection was found to be a high risk factor (39 %, vs. 7 % followed by segmental or no resection, p < 0.0001).CONCLUSION:
Marginal or periosteal bone resection of the mandible was identified as the highest ORN risk factor in our IMRT cohort.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Osteorradionecrose
/
Neoplasias Otorrinolaringológicas
/
Radioterapia de Intensidade Modulada
/
Mandíbula
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Strahlenther Onkol
Assunto da revista:
NEOPLASIAS
/
RADIOTERAPIA
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Suíça