Read More...A retrospective review of the incidence of osteoradionecrosis in Head and Neck Cancer (HNC) patients in Southern Ireland, 2010-2021 and factors associated with its development.">
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A retrospective review of the incidence of osteoradionecrosis in Head and Neck Cancer (HNC) patients in Southern Ireland, 2010-2021 and factors associated with its development.


Authors: Ciara Lyons,Eleanor O’Sullivan,Kate Fitzgerald
Publication: Journal of The Irish Head and Neck Society - 2023
Issue: 1 Volume: 1
Published: June, 2023 View PDF

Background: Osteoradionecrosis (ORN) is a debilitating long-term side effect of radiotherapy (RT) treatment in HNC patients. International incidence rates range from 0.4% to 56%. This is a novel Irish study that assesses ORN incidence rates in HNC patients attending the CUDSH Dental Oncology Unit (2010-2021) and explores potential precipitating factors.

Methods: Retrospective review of 1,050 HNC patients treated in Dental Oncology (2010-2021) identified 47 patients who developed ORN. Their medical, dental and radiotherapy records were retrospectively reviewed; patient, tumour, ORN and treatment-related variables were extracted and analyzed using SPSS and Pearsons Chi-square test.

Results: ORN incidence rate was low (4.4%). Median time to ORN development was 21 months. Seventeen ORN patients received pre-RT mandibular surgery. ORN development in the surgical site was statistically significant (p<.001), at radiation dose ≥ 60 Gy (p=.035), within 12 months of RT treatment (p=.044), due to induced causes (p=.029), and without resolution (p=.019).

Conclusion: Low incidence rates suggest intensive dental intervention is beneficial in reducing ORN risk. Site of pre-RT mandibular bone surgery was a significant risk factor for ORN. These practice changing findings suggest that contouring the bone surgery site and assigning a dose constraint to these areas, where feasible, may minimize ORN risk.

 

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