Risk factors for osteoradionecrosis after head and neck radiation: A systematic review

Syed Nabil Syed Omar, Nabil Samman

Research output: Contribution to journalArticle

104 Citations (Scopus)

Abstract

Objective. This systematic review aimed to answer the clinical question, "What is the current risk of developing osteoradionecrosis of the jaws among irradiated head and neck cancer patients?" Study Design. A systematic review of published English-language randomized controlled trials on the outcome of radiation therapy was performed via Medline and Embase databases. Data on osteoradionecrosis/bone toxicity were collected and analyzed. Results. Twenty-two articles reporting on a total of 5,742 patients were selected for final review based on strict eligibility criteria. An estimated 2% of the head and neck-irradiated patients are at risk of developing osteoradionecrosis. Patients receiving adjunctive radiotherapy, accelerated fractionation without dose reduction, and chemoradiotherapy show no increase in osteoradionecrosis risk. Accelerated fractionation with dose reduction is associated with a reduced risk, whereas hyperfractionation shows elevated risk of developing osteoradionecrosis. Conclusions. The risk of developing osteoradionecrosis among the irradiated head and neck cancer patient has significantly declined in recent years.

Original languageEnglish
Pages (from-to)54-69
Number of pages16
JournalOral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Volume113
Issue number1
DOIs
Publication statusPublished - Jan 2012

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Osteoradionecrosis
Neck
Head
Radiation
Dose Fractionation
Head and Neck Neoplasms
Radiotherapy
Chemoradiotherapy
Jaw
Language
Randomized Controlled Trials
Databases
Bone and Bones

ASJC Scopus subject areas

  • Surgery
  • Oral Surgery
  • Pathology and Forensic Medicine
  • Radiology Nuclear Medicine and imaging
  • Dentistry (miscellaneous)

Cite this

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title = "Risk factors for osteoradionecrosis after head and neck radiation: A systematic review",
abstract = "Objective. This systematic review aimed to answer the clinical question, {"}What is the current risk of developing osteoradionecrosis of the jaws among irradiated head and neck cancer patients?{"} Study Design. A systematic review of published English-language randomized controlled trials on the outcome of radiation therapy was performed via Medline and Embase databases. Data on osteoradionecrosis/bone toxicity were collected and analyzed. Results. Twenty-two articles reporting on a total of 5,742 patients were selected for final review based on strict eligibility criteria. An estimated 2{\%} of the head and neck-irradiated patients are at risk of developing osteoradionecrosis. Patients receiving adjunctive radiotherapy, accelerated fractionation without dose reduction, and chemoradiotherapy show no increase in osteoradionecrosis risk. Accelerated fractionation with dose reduction is associated with a reduced risk, whereas hyperfractionation shows elevated risk of developing osteoradionecrosis. Conclusions. The risk of developing osteoradionecrosis among the irradiated head and neck cancer patient has significantly declined in recent years.",
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N2 - Objective. This systematic review aimed to answer the clinical question, "What is the current risk of developing osteoradionecrosis of the jaws among irradiated head and neck cancer patients?" Study Design. A systematic review of published English-language randomized controlled trials on the outcome of radiation therapy was performed via Medline and Embase databases. Data on osteoradionecrosis/bone toxicity were collected and analyzed. Results. Twenty-two articles reporting on a total of 5,742 patients were selected for final review based on strict eligibility criteria. An estimated 2% of the head and neck-irradiated patients are at risk of developing osteoradionecrosis. Patients receiving adjunctive radiotherapy, accelerated fractionation without dose reduction, and chemoradiotherapy show no increase in osteoradionecrosis risk. Accelerated fractionation with dose reduction is associated with a reduced risk, whereas hyperfractionation shows elevated risk of developing osteoradionecrosis. Conclusions. The risk of developing osteoradionecrosis among the irradiated head and neck cancer patient has significantly declined in recent years.

AB - Objective. This systematic review aimed to answer the clinical question, "What is the current risk of developing osteoradionecrosis of the jaws among irradiated head and neck cancer patients?" Study Design. A systematic review of published English-language randomized controlled trials on the outcome of radiation therapy was performed via Medline and Embase databases. Data on osteoradionecrosis/bone toxicity were collected and analyzed. Results. Twenty-two articles reporting on a total of 5,742 patients were selected for final review based on strict eligibility criteria. An estimated 2% of the head and neck-irradiated patients are at risk of developing osteoradionecrosis. Patients receiving adjunctive radiotherapy, accelerated fractionation without dose reduction, and chemoradiotherapy show no increase in osteoradionecrosis risk. Accelerated fractionation with dose reduction is associated with a reduced risk, whereas hyperfractionation shows elevated risk of developing osteoradionecrosis. Conclusions. The risk of developing osteoradionecrosis among the irradiated head and neck cancer patient has significantly declined in recent years.

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