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Risk factors for osteoradionecrosis of the jaw in patients with head and neck squamous cell carcinoma.
Kubota, Hikaru; Miyawaki, Daisuke; Mukumoto, Naritoshi; Ishihara, Takeaki; Matsumura, Megumi; Hasegawa, Takumi; Akashi, Masaya; Kiyota, Naomi; Shinomiya, Hirotaka; Teshima, Masanori; Nibu, Ken-Ichi; Sasaki, Ryohei.
Afiliação
  • Kubota H; Division of Radiation Oncology, Kobe University Hospital, Kobe, Hyogo, Japan.
  • Miyawaki D; Division of Radiation Oncology, Kobe University Hospital, Kobe, Hyogo, Japan.
  • Mukumoto N; Division of Radiation Oncology, Kobe University Hospital, Kobe, Hyogo, Japan.
  • Ishihara T; Division of Radiation Oncology, Kobe University Hospital, Kobe, Hyogo, Japan.
  • Matsumura M; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
  • Hasegawa T; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
  • Akashi M; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
  • Kiyota N; Kobe University Hospital Cancer Center, Kobe, Japan.
  • Shinomiya H; Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
  • Teshima M; Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
  • Nibu KI; Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
  • Sasaki R; Division of Radiation Oncology, Kobe University Hospital, Kobe, Hyogo, Japan. rsasaki@med.kobe-u.ac.jp.
Radiat Oncol ; 16(1): 1, 2021 Jan 05.
Article em En | MEDLINE | ID: mdl-33402192
ABSTRACT

BACKGROUND:

To evaluate factors associated with osteoradionecrosis of the jaw (ORNJ) in patients with head and neck squamous cell carcinoma (HNSCC), focusing on jaw-related dose-volume histogram (DVH) parameters.

METHODS:

We retrospectively reviewed the medical records of 616 patients with HNSCC treated with curative-intent or postoperative radiation therapy (RT) during 2008-2018. Patient-related (age, sex, history of smoking or alcohol use, diabetes mellitus, performance status, pre-RT dental evaluation, pre- or post-RT tooth extraction), tumor-related (primary tumor site, T-stage, nodal status), and treatment-related (pre-RT surgery, pre-RT mandible surgery, induction or concurrent chemotherapy, RT technique) variables and DVH parameters (relative volumes of the jaw exposed to doses of 10 Gy-70 Gy [V10-70]) were investigated and compared between patients with and without ORNJ. The Mann-Whitney U test was used to compare RT dose parameters. Univariate and multivariate Cox regression analyses were used to assess factors associated with ORNJ development. Kaplan-Meier analyses were performed for cumulative ORNJ incidence estimation.

RESULTS:

Forty-six patients (7.5%) developed ORNJ. The median follow-up duration was 40 (range 3-145) months. The median time to ORNJ development was 27 (range 2-127) months. DVH analysis revealed that V30-V70 values were significantly higher in patients with than in those without ORNJ. In univariate analyses, primary tumor site, pre-RT mandible surgery, post-RT tooth extraction, and V60 > 14% were identified as important factors. In multivariate analyses, V60 > 14% (p = 0.0065) and primary tumor site (p = 0.0059) remained significant. The 3-year cumulative ORNJ incidence rates were 2.5% and 8.6% in patients with V60 ≤ 14% and > 14%, respectively (p < 0.0001), and 9.3% and 1.4% in patients with oropharyngeal or oral cancer and other cancers, respectively (p < 0.0001).

CONCLUSIONS:

V60 > 14% and oropharyngeal or oral cancer were found to be independent risk factors for ORNJ. These findings might be useful to minimize ORNJ incidence in HNSCC treated with curative RT.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Osteorradionecrose / Doenças Maxilomandibulares / Radioterapia de Intensidade Modulada / Carcinoma de Células Escamosas de Cabeça e Pescoço / Neoplasias de Cabeça e Pescoço 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: Radiat Oncol Assunto da revista: NEOPLASIAS / RADIOTERAPIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Japão

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Osteorradionecrose / Doenças Maxilomandibulares / Radioterapia de Intensidade Modulada / Carcinoma de Células Escamosas de Cabeça e Pescoço / Neoplasias de Cabeça e Pescoço 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: Radiat Oncol Assunto da revista: NEOPLASIAS / RADIOTERAPIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Japão