Long-term follow-up of osteoradionecrosis of the mandible

Authors

  • Ghazaleh Boromand Department of Oral and Maxillofacial Surgery, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  • Hedda Haugen-Cange Department of Oncology, Institute of Clinical Sciences at Gothenburg University and Sahlgrenska University Hospital, Gothenburg, Sweden
  • Martin Asparusova Department of Oral and Maxillofacial Surgery, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  • Annika Ekestubbe Department of Oral and Maxillofacial Radiology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  • Goran Kjeller Department of Oral and Maxillofacial Surgery, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

DOI:

https://doi.org/10.1080/00016357.2023.2257316

Keywords:

Osteoradionecrosis, radiation therapy, mandible, oropharyngeal cancer

Abstract

Aim: Investigating the prevalence of mandibular ORN in a single Swedish Oncology Center.

Methods: Atotal of 450 patients, treated with radiotherapy for squamous cell carcinoma in the oropharynx between 2004 and 2014 were included. Three different techniques of radiotherapy were studied. ORN diagnosis was set when clinical signs according to Marx were observed, or if radiological signs were staged according to Schwartz and Kagan.

Results: Using the staging system, 90 patients (20%) were diagnosed with ORN. The mean age of the ORN patients was 56.6 years, the older the patient the lower the risk of developing ORN (p = .01). The risk of developing ORN for patients receiving Intensity Modulated Radiotherapy was lower compared to patients treated with the other techniques in the multivariable analysis. Brachytherapy significantly increases the risk of ORN. The risk of ORN increased by 8% each year after radiation (p = .04). The mean time to the ORN diagnosis was 3.9 years. In the multivariate analysis, the risk of ORN increased by 13% each year after radiation (p = .0013).

Conclusion: The mean radiation dose was of greater importance for the risk of ORN than the maximum dose. Elderly people with oropharyngeal cancer were less prone to develop ORN. 

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Published

2024-09-17

Issue

Vol. 82: Acta Odontologica Scandinavica

Section

Research article