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Open Access 01-01-2016 | Original Article

Risk profile for osteoradionecrosis of the mandible in the IMRT era

Authors: Prof. Gabriela Studer, Marius Bredell, BChD, MBChB, MChD, Stephan Studer, PD, Gerhard Huber, PD, Prof. Christoph Glanzmann

Published in: Strahlentherapie und Onkologie | Issue 1/2016

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 and methods

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.

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Title: Risk profile for osteoradionecrosis of the mandible in the IMRT era
Authors: Prof. Gabriela Studer
Marius Bredell, BChD, MBChB, MChD
Stephan Studer, PD
Gerhard Huber, PD
Prof. Christoph Glanzmann
Publication date: 01-01-2016
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 1/2016
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-015-0875-6

At a glance: The STEP trials

Springer Medicine

Risk profile for osteoradionecrosis of the mandible in the IMRT era

Abstract

Background

Patients and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusion

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