Three-dimensional (3D) anatomic location, extension, and timing of severe osteoradionecrosis of the mandible.

Autor:	Sapienza LG; Department of Radiation Oncology, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, United States., Thomas JJ; Department of Radiation Oncology, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, United States., Mai W; Department of Radiation Oncology, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, United States.; Department of Radiation Oncology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States., Hanania AN; Department of Radiation Oncology, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, United States., Hunjan S; Department of Radiation Oncology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States., Sandulache VC; ENT Section - Operative Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States.; Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, TX, United States., Chen AC; Department of Radiation Oncology, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, United States.; Department of Radiation Oncology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States.
Jazyk:	angličtina
Zdroj:	Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology [Rep Pract Oncol Radiother] 2022 Jul 29; Vol. 27 (3), pp. 519-526. Date of Electronic Publication: 2022 Jul 29 (Print Publication: 2022).
DOI:	10.5603/RPOR.a2022.0057
Abstrakt:	Background: The purpose of this study was to describe the topography, extension (volume), and timing of severe osteoradionecrosis (ORN) that required mandible resection in patients previously treated for head and neck cancer at a high-volume Veterans Affairs Medical Center. Materials and Methods: The records from a reference hyperbaric oxygen clinic were retrospectively analyzed (n = 50, 2018-2021). Inclusion criteria were: I) severe ORN defined as progressive ORN that required resection; II) pathologic confirmation of ORN; and III) availability of pre-operative CT-imaging. Using a radiotherapy (RT) imaging software, we performed a detailed volumetric (3D) analysis of the bone involvement by ORN. Time intervals from RT to surgery for ORN and from surgery to the last follow-up were calculated. Results: All patients that met inclusion criteria (n = 10) were male with significant smoking history (median 47.5 pack-years) and a median age of 57 years old at the time of RT. The primary tumors were: oropharynx (n = 6), oral cavity (n = 3) and nasopharynx (n = 1). The median time from RT to ORN surgery was 8 years. The most common ORN location was the posterior lateral body (molar) and six patients had associated fractures. The mean ORN volume was 3.6 cc (range: 0.6-8.3), corresponding to a mean 6.3% (range: 0.7-14) of the total mandibular volume. After a median follow-up of 13.5 months, no recurrence of ORN occurred. Three patients died of non-cancer and non-ORN-recurrence related causes (1 y OS 77.1%). Conclusion: Severe ORN occurred after a median of 8 years from the previous RT and usually affected the posterior lateral body. Surgical resection achieved excellent ORN control. Competing Interests: Conflicts of interest None declared. (© 2022 Greater Poland Cancer Centre.)
Databáze:	MEDLINE
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