Osteoradionecrosis and intensity modulated radiation therapy: An overview

Area of Science:

• Oncology
• Radiotherapy
• Oral and Maxillofacial Surgery

Background:

• Osteoradionecrosis (ORN) remains a significant concern in head and neck cancer treatment.
• Understanding the incidence and management of ORN, particularly in the context of advanced radiotherapy techniques, is crucial.
• The mandible is a critical organ at risk during radiotherapy, susceptible to radiation-induced damage.

Purpose of the Study:

• To investigate the incidence of osteoradionecrosis in the intensity modulated radiotherapy (IMRT) era.
• To review the literature regarding radiation damage to the mandible.
• To discuss optimal dose constraints and the role of IMRT in minimizing radiation dose to the mandible.

Main Methods:

• A comprehensive literature search was performed using PubMed.
• The review focused on studies reporting on osteoradionecrosis, mandible dose constraints, and IMRT techniques.
• Evidence of radiation damage to the mandible was critically evaluated.

Main Results:

• IMRT aims to reduce radiation dose to organs at risk, including the mandible.
• Specific dose constraints for the mandible are discussed in the context of minimizing ORN risk.
• The literature review provides insights into the current understanding of ORN incidence with IMRT.

Conclusions:

• Optimizing radiation therapy planning with IMRT is essential for reducing the risk of osteoradionecrosis.
• Further research is needed to establish definitive incidence rates and optimal dose constraints for the mandible in the IMRT era.
• Effective management strategies for ORN require a thorough understanding of its pathogenesis and prevention through dose reduction.