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Irradiated bone and its management

P D Costantino1, C D Friedman, M J Steinberg

  • 1Section of Head and Neck Surgical Oncology, Loyola University Cancer Center, Maywood, IL 60153, USA.

Otolaryngologic Clinics of North America
|October 1, 1995
PubMed
Summary
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Radiotherapy for head and neck cancers can damage bone. Preventive measures, dental care, hyperbaric oxygen, antibiotics, and reconstructive surgery can mitigate and treat these radiation-induced bone complications.

Area of Science:

  • Oncology
  • Oral and Maxillofacial Surgery
  • Radiation Oncology

Background:

  • Radiotherapy is crucial for head and neck cancer treatment but causes significant damage to surrounding tissues, particularly bone.
  • Radiation-induced osteonecrosis (ORN) and other bone complications are serious side effects that can impair quality of life.

Purpose of the Study:

  • To review and outline current strategies for preventing and managing radiation-induced bone damage in head and neck cancer patients.
  • To emphasize the importance of a multidisciplinary approach involving surgeons, dentists, and radiation oncologists.

Main Methods:

  • Review of preventive measures including dose limitation, shielding, salivary gland sparing, and pre-radiation dental care.
  • Discussion of treatments for established ORN, such as hyperbaric oxygen therapy and antibiotics.

Related Experiment Videos

  • Overview of reconstructive options for mandibular defects, including bone grafting and microvascular tissue transfer.

    • Main Results:

    • Preventive strategies, when implemented before or during radiotherapy, can significantly reduce the incidence and severity of bone complications.
    • Various treatment modalities exist for managing ORN, ranging from conservative measures to surgical reconstruction.
    • Differentiating radiation-induced wound healing issues from tumor recurrence is critical for appropriate management.

    Conclusions:

    • A comprehensive approach combining preventive strategies, timely intervention, and appropriate treatment is essential for managing radiation-induced bone complications.
    • Head and neck surgeons play a vital role in ensuring these measures are utilized for optimal patient outcomes.
    • Early and accurate diagnosis, distinguishing wound healing problems from tumor recurrence, is the paramount first step in treating radiation-induced wounds.