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  • Title: Factors predictive of severity of osteoradionecrosis of the mandible.
    Author: Chopra S, Kamdar D, Ugur OE, Chen G, Peshek B, Marunick M, Kim H, Lin HS, Jacobs J.
    Journal: Head Neck; 2011 Nov; 33(11):1600-5. PubMed ID: 21484922.
    Abstract:
    BACKGROUND: An analysis of risk factors predictive of severe mandibular osteoradionecrosis (ORN) is needed to aid prophylaxis and management of this condition. METHODS: We retrospectively analyzed 46 patients diagnosed between June 2002 and March 2009: 93% had mandibular ORN, which was staged 0 to III (Store and Boysen). Patient, tumor, treatment-related, and other variables were analyzed for association with mandibular ORN severity. RESULTS: Oral or oropharyngeal tumors comprised 85% of our primary tumors, 80% were stage IV, and 91% were squamous cell carcinomas. Most patients (87%) received 3-dimensional (3D) conformal radiation therapy (RT), with 60 Gray (Gy) median dose; 28% and 72% received primary and adjuvant RT, respectively; 78% received chemotherapy, mostly concurrent (97%) and platinum-based (96%). Median time to development of ORN was 7.5 months. White ethnicity and secondary infection correlated significantly with stage III mandibular ORN (p = .038, p = .0007, respectively). Advanced age, stage IV, RT dose, post-RT, and lack of pre-RT dental extractions appeared predictive of severe mandibular ORN. CONCLUSIONS: The above-cited factors are predictive of severity and can potentially guide prophylaxis and management.
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