Timing of development of osteoradionecrosis post head and neck radiotherapy: does a safe time interval exist for dental extraction?
Dental intervention
Head and neck cancer
Osteoradionecrosis
Radiotherapy
Time factors
Journal
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]
ISSN: 1439-099X
Titre abrégé: Strahlenther Onkol
Pays: Germany
ID NLM: 8603469
Informations de publication
Date de publication:
25 Jun 2024
25 Jun 2024
Historique:
received:
25
02
2024
accepted:
26
05
2024
medline:
26
6
2024
pubmed:
26
6
2024
entrez:
25
6
2024
Statut:
aheadofprint
Résumé
Risk factors for developing osteoradionecrosis (ORN) are well known, but less is known about factors influencing the interval between radiotherapy and the onset of ORN. Also, it is unknown whether there is any specific period post-radiotherapy with a reduced probability of ORN when irradiated teeth require extraction. The primary aim of this study was to identify factors influencing the interval in developing ORN in the following subgroups of patients: (1) patients who spontaneously developed ORN, (2) surgical-intervention-related ORN with a particular focus on patients after mandibulectomy. The secondary aim was to attempt to identify a possible time for safer dental intervention after primary treatment. The authors retrospectively analysed 1608 head and neck cancer (HNC) patients treated in a single centre. Time intervals were measured from the end of radiotherapy to the development of ORN and further analysed in the subgroups listed above. In all, 141 patients (8.8%) developed intra-oral ORN. Median time from radiotherapy to ORN development in the whole cohort was 9 months. Median interval for spontaneous ORN was 8 months, 6.5 months for intervention-related ORN, and 15 months for patients post-mandibulectomy. In patients who required dental extraction preradiotherapy, median interval of ORN onset was 5 months. In our study, a slightly higher proportion of patients with intervention developed ORN earlier in comparison with spontaneous ORN. The period from 12-18 months after radiotherapy was identified as having the highest probability of developing ORN in patients after mandibulectomy. A time for safer dental intervention after primary treatment was not identified.
Identifiants
pubmed: 38918259
doi: 10.1007/s00066-024-02251-5
pii: 10.1007/s00066-024-02251-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. Crown.
Références
Baxi SS, Pinheiro LC, Pati SM, Pfister DG, Oeffinger KC, Elkin EB (2014) Causes of death in long term survivors of head and neck cancer. Cancer 120:1507–1513
doi: 10.1002/cncr.28588
pubmed: 24863390
Tsai CJ, Hofstede TM, Sturgis EM, Garden AS, Lindberg ME, Wei Q, Tucker SL, Dong L (2013) Osteoradionecrosis and radiation dose to the mandible in patients with oropharyngeal cancer. Int J Radiat Oncol Biol Phys 85(2):415–420
doi: 10.1016/j.ijrobp.2012.05.032
pubmed: 22795804
Aarup-Kristensen S, Hansen CR, Fornber L, Brink C, Eriksen JG, Johansen J Osteoradionecrosis of the mandible after radiotherapy for head and neck cancer: risk factors and dose-volume correlations. Acta Oncol. https://doi.org/10.1080/0284186X.2019.1643037
Caparrotti F, Huang SH, Lu L, Bratman SV, Ringash J, Bayley A, Cho J, Giuliani M, Kim J, Waldron J, Hansen A, Tong L, Xu W, O’Sullivan B, Wood R, Goldstein D, Hope A (2017) Osteoradionecrosis of the mandible in patients with oropharyngeal carcinoma treated with intensity-modulated radiotherapy. Cancer 123(19):3691–3700. https://doi.org/10.1002/cncr.30803
doi: 10.1002/cncr.30803
pubmed: 28608925
Kovarik JP, Voborna I, Barclay S, Iqbal MS, Cunnell M, Kelly C, Willis N, Kennedy M, Kovarik J (2022) Osteoradionecrosis after treatment of head and neck cancer: a comprehensive analysis of risk factors with a particular focus on role of dental extractions. Br J Oral Maxillofac Surg 60(2):168–173. https://doi.org/10.1016/j.bjoms.2021.03.009
doi: 10.1016/j.bjoms.2021.03.009
pubmed: 34857411
Notani K, Yamazaki Y, Kitada H, Sakakibara N, Fukuda H, Omori K, Nakamura M (2003) Management of mandibular osteoradionecrosis corresponding to the severity of osteoradionecrosis and the method of radiotherapy. Head Neck 25(3):181–186. https://doi.org/10.1002/hed.10171
doi: 10.1002/hed.10171
pubmed: 12599284
Kubota H, Miyawaki D, Mukumoto N et al (2021) Risk factors for osteoradionecrosis of the jaw in patients with head and neck squamous cell carcinoma. Radiat Oncol. https://doi.org/10.1186/s13014-020-01701-5
doi: 10.1186/s13014-020-01701-5
pubmed: 34147099
pmcid: 8214783
Owosho AA, Tsai CJ, Lee RS, Freymiller H, Kadempour A, Varthis S et al (2017) The prevalence and risk factors associated with osteoradionecrosis of the jaw in oral and oropharyngeal cancer patients treated ith intensity-modulated radiation therapy: the memorial Sloan Kettering cancer center experience. Oral Oncol 64:44–51. https://doi.org/10.1016/j.oraloncology.2016.11.015
doi: 10.1016/j.oraloncology.2016.11.015
pubmed: 28024723
Reuther T, Schuster T, Mende U, Kübler A (2003) Osteoradionecrosis of the jaws as a side effect of radiotherapy of head and neck tumour patients—a report of a thirty year retrospective review. Int J Oral Maxillofac Surg 32(3):289–295. https://doi.org/10.1054/ijom.2002.0332
doi: 10.1054/ijom.2002.0332
pubmed: 12767877
Moon DH, Moon SH, Wang K, Weissler MC, Hackman TG, Zanation AM et al (2017) Incidence of, and risk factors for, mandibular osteoradionecrosis in patients with oral cavity and oropharynx cancers. Oral Oncol 72:98–103. https://doi.org/10.1016/j.oraloncology.2017.07.014
doi: 10.1016/j.oraloncology.2017.07.014
pubmed: 28797468
Kabir R, Durand R, Roberge D, Dufresne E, Nguyen-Tân PF (2022) Incidence of osteoradionecrosis of the jaws: a retrospective study of 620 patients with head and neck cancer. Gen Dent 70(4):72–77
pubmed: 35749251
Kuhnt T, Stang A, Wienke A, Vordermark D, Schweyen R, Hey J (2016) Potential risk factors for jaw osteoradionecrosis after radiotherapy for head and neck cancer. Radiat Oncol 11:101. https://doi.org/10.1186/s13014-016-0679-6
doi: 10.1186/s13014-016-0679-6
pubmed: 27473433
pmcid: 4967325
Chang DT, Sandow PR, Morris CG, Hollander R, Scarborough L, Amdur RJ, Mendenhall WM (2007) Do pre-irradiation dental extractions reduce the risk of osteoradionecrosis of the mandible? Head Neck 29(6):528–536. https://doi.org/10.1002/hed.20538
doi: 10.1002/hed.20538
pubmed: 17230555
van Dijk LV, Abusaif AA, Rigert J, Naser MA, Hutcheson KA, Lai SY, Fuller CD, Mohamed ASR, MD Anderson Symptom Working Group. (2021) Normal tissue complication probability (NTCP) prediction model for osteoradionecrosis of the mandible in patients with head and neck cancer after radiation therapy: large-scale observational cohort. Int J Radiat Oncol Biol Phys 111(2):549–558. https://doi.org/10.1016/j.ijrobp.2021.04.042
doi: 10.1016/j.ijrobp.2021.04.042
pubmed: 33965514
pmcid: 8906058
Möring MM, Mast H, Wolvius EB, Verduijn GM, Petit SF, Sijtsema ND, Jonker BP, Nout RA, Heemsbergen WD (2022) Osteoradionecrosis after postoperative radiotherapy for oral cavity cancer: a retrospective cohort study. Oral Oncol 133:106056. https://doi.org/10.1016/j.oraloncology.2022.106056
doi: 10.1016/j.oraloncology.2022.106056
pubmed: 35933938
Lee CT, Litwin S, Yao CMKL, Liu JC, Ridge JA, Galloway TJ (2022) Osteoradionecrosis rate in oropharynx cancer treated with dose volume histogram based constraints. Radiother Oncol 176:215–221. https://doi.org/10.1016/j.radonc.2022.10.011
doi: 10.1016/j.radonc.2022.10.011
pubmed: 36252636
Studer G, Bredell M, Studer S, Huber G, Glanzmann C (2016) Risk profile for osteoradionecrosis of the mandible in the IMRT era. Strahlenther Onkol 192(1):32–39. https://doi.org/10.1007/s00066-015-0875-6
doi: 10.1007/s00066-015-0875-6
pubmed: 26265308
Kovarik JP, Voborna I, Barclay S, Nicol A, Kelly C, Kovarik PD, Iqbal MS, Kovarik J (2021) Dental loss after radiotherapy for head and neck cancer. Br Dent J 231(8):473–478. https://doi.org/10.1038/s41415-021-3536-4
doi: 10.1038/s41415-021-3536-4
pubmed: 34686814
Vigarios E, Epstein JB, Sibaud V (2017) Oral mucosal changes induced by anticancer targeted therapies and immune checkpoint inhibitors. Support Care Cancer 25:1713–1739
doi: 10.1007/s00520-017-3629-4
pubmed: 28224235
Beumer J III, Harrison R, Sanders B, Kurrasch M (1983) Postradiation dental extractions: a review of the literature and a report of 72 episodes. Head Neck 6:581–586. https://doi.org/10.1002/hed.2890060107
doi: 10.1002/hed.2890060107
Thorn JJ, Hansen HS, Specht L, Bastholt L (2000) Osteoradionecrosis of the jaws: clinical characteristics and relation to the field of irradiation. J Oral Maxillofac Surg 58(10):1088–1093. https://doi.org/10.1053/joms.2000.9562 (discussion 1093–5)
doi: 10.1053/joms.2000.9562
pubmed: 11021701
Marx RE (1983) Osteoradionecrosis: a new concept of its pathophysiology. J Oral Maxillofac Surg 41(5):283–288. https://doi.org/10.1016/0278-2391(83)90294-x
doi: 10.1016/0278-2391(83)90294-x
pubmed: 6572704
Kovarik PDE, Patil R, Cvek J, Kelly C, Jackson M, Mackenzie L, West N, Willis N, Kovarik JP, Banks R, Kennedy M, Adams J, Iqbal MS (2023) Extra-mandibular osteoradionecrosis after the treatment of head and neck cancer. Clin Oncol 35(9):e498–e505. https://doi.org/10.1016/j.clon.2023.06.013
doi: 10.1016/j.clon.2023.06.013