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Radiotherapy-induced mandibular bone complications.

Barbara A Jereczek-Fossa1, Roberto Orecchia

  • 1Division of Radiotherapy, European Institute of Oncology, via Ripamonti 435, 20141 Milan, Italy. barbara.fossa@ieo.it

Cancer Treatment Reviews
|May 25, 2002
PubMed
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Osteoradionecrosis (ORN) is a severe complication affecting the mandible after radiation therapy for head and neck cancers. While incidence varies, improved preventive care and radiotherapy techniques are decreasing ORN rates.

Area of Science:

  • Oncology
  • Oral and Maxillofacial Surgery
  • Radiation Oncology

Background:

  • The mandible is frequently affected by irradiation, with osteoradionecrosis (ORN) being the most severe post-radiation injury.
  • Reported incidence of mandibular ORN in head and neck cancer patients varies widely (0.4%–56%), complicated by diverse evaluation methods.
  • Patients face an indefinite risk of ORN, typically manifesting within three years post-radiotherapy.

Purpose of the Study:

  • To review the incidence, etiology, and management of osteoradionecrosis of the mandible (ORN).
  • To discuss factors contributing to ORN risk and current diagnostic and therapeutic approaches.
  • To highlight the impact of improved preventive measures and radiotherapy techniques on ORN incidence.

Main Methods:

Related Experiment Videos

  • Literature review of studies on mandibular osteoradionecrosis (ORN) following radiotherapy for head and neck cancers.
  • Analysis of diagnostic criteria, including clinical presentation and radiological findings.
  • Evaluation of risk factors, conservative management, and surgical interventions for ORN.

    • Main Results:

    • Diagnosis of ORN relies on clinical signs of exposed bone and radiological evidence of bone damage.
    • Numerous factors, including treatment, patient, and tumor variables, are associated with ORN risk.
    • Conservative management (e.g., hyperbaric oxygen) and surgical resection are primary treatment modalities.

    Conclusions:

    • While ORN incidence has decreased due to enhanced preventive strategies and radiotherapy advancements, it remains a significant concern.
    • Continued research is essential to further mitigate the severe impact of ORN on patient quality of life.
    • Multidisciplinary approaches involving oral hygiene, dental evaluation, and refined radiotherapy techniques are crucial for ORN prevention and management.