Analysis of the critical dose of radiation therapy in the incidence of Osteoradionecrosis in head and neck cancer patients: a case series

Zain Iqbal; Panayiotis Kyzas

doi:10.1038/s41405-020-00044-3

Analysis of the critical dose of radiation therapy in the incidence of Osteoradionecrosis in head and neck cancer patients: a case series

BDJ Open. 2020 Sep 24:6:18. doi: 10.1038/s41405-020-00044-3. eCollection 2020.

Authors

Zain Iqbal^{1

2}, Panayiotis Kyzas^{1

2}

Affiliations

¹ The University of Manchester, Manchester, UK.
² The Department of Oral and Maxillofacial Surgery, North Manchester General Hospital, Northern Care Alliance NHS Group, Manchester, UK.

Abstract

Introduction: Osteoradionecrosis (ORN) is a dramatic complication following radiation therapy (RT) for head and neck tumours. Symptoms include pain, trismus, and malodour. ORN can present with exposed necrotic bone, an orocutaneous fistula, and/ or a pathological fracture.

Aims: To analyse the RT dose responsible for the pathogenesis of ORN and its associated risk factors.

Methods: The data of 17 patients from 2005 to 2017 were retrospectively reviewed from the Pinnacle(3), WebPublication, and Electronic patient records (EPR) provided by Christie Hospital and Pennine Acute NHS Trust.

Results: The mean RT dose that ORN sites received was 57.3 Gy. The mean onset duration for ORN after RT was 640.6 days. six patients (35.2%) developed ORN following post-RT dental extractions.

Conclusion: RT dosages of >57.3 Gy significantly increase the likelihood of developing ORN. Mandibular surgery, post-RT dental extraction, concurrent smoking, and alcohol abuse all amplify the risk of developing ORN.

Keywords: Oral cancer; Oral pathology.