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Supportive Care in Cancer
Published in: Supportive Care in Cancer 8/2010

01-08-2010 | Review Article

Osteoradionecrosis in cancer patients: the evidence base for treatment-dependent frequency, current management strategies, and future studies

Authors: Douglas E. Peterson, Wolfgang Doerr, Allan Hovan, Andres Pinto, Debbie Saunders, Linda S. Elting, Fred K. L. Spijkervet, Michael T. Brennan

Published in: Supportive Care in Cancer | Issue 8/2010

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Abstract

Purpose

The purpose of this study is to review the evidence base from 1990 to 2008 to (1) clarify the impact of cancer therapies on prevalence of osteoradionecrosis (ORN) in head and neck cancer patients, and to (2) evaluate management strategies and their consequences on quality of life and cost of care.

Methods

Articles were selected for the time period beginning after 1989, excluding the 1990 NCI monograph articles from the 1989 NIH-sponsored Oral Complications in Cancer Therapy Symposium that was published in 1990. The search included both Medline/PubMed and Embase and was limited to humans. The search was limited to publications in the English language. No abstracts were utilized in the current review. Each article was evaluated by two reviewers. A weighted prevalence was calculated for the prevalence of ORN while incorporating predetermined quality measures. The level of evidence, recommendation grade, and guideline (if possible) were provided for published preventive and management strategies for ORN.

Results

A total of 43 articles between 1990 and 2008 were reviewed. The weighted prevalence for ORN included conventional radiotherapy (RT) = 7.4%, intensity modulated RT (IMRT) = 5.1%, chemoradiotherapy (CRT) = 6.8%, and brachytherapy = 5.3%. Hyperbaric oxygen may contribute a role in management of ORN. However, no clear guideline recommendations could be established for the prevention or treatment of ORN based on the literature reviewed.

Conclusions

New cancer treatment modalities such as IMRT and concomitant CRT have had minimal effect on prevalence of ORN. No studies to date have systematically addressed impact of ORN on either quality of life or cost of care.
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Metadata
Title
Osteoradionecrosis in cancer patients: the evidence base for treatment-dependent frequency, current management strategies, and future studies
Authors
Douglas E. Peterson
Wolfgang Doerr
Allan Hovan
Andres Pinto
Debbie Saunders
Linda S. Elting
Fred K. L. Spijkervet
Michael T. Brennan
Publication date
01-08-2010
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 8/2010
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-010-0898-6

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