Browse by author
Lookup NU author(s): Dr Charles Kelly, Michael Jackson, Nick West, Dr Naomi Willis
Full text for this publication is not currently held within this repository. Alternative links are provided below where available.
© 2023. Aims: Osteoradionecrosis (ORN) is a serious toxicity of head and neck radiotherapy. It predominantly affects the mandible. Extra-mandibular ORN is rare. The aim of this study was to report the incidence and outcomes of extra-mandibular ORNs from a large institutional database. Materials and methods: In total, 2303 head and neck cancer patients were treated with radical or adjuvant radiotherapy. Of these, extra-mandibular ORN developed in 13 patients (0.5%). Results: Maxillary ORNs (n = 8) were a consequence of the treatment of various primaries (oropharynx = 3, sinonasal = 2, maxilla = 2, parotid = 1). The median interval from the end of radiotherapy to the development of ORN was 7.5 months (range 3–42 months). The median radiotherapy dose in the centre of the ORN was 48.5 Gy (range 22–66.5 Gy). Four patients (50%) healed in 7, 14, 20 and 41 months. All temporal bone ORNs (n = 5) developed after treatment to the parotid gland (of a total of 115 patients who received radiotherapy for parotid gland malignancy). The median interval from the end of radiotherapy to the development of ORN was 41 months (range 20–68 months). The median total dose in the centre of the ORN was 63.5 Gy (range 60.2–65.3 Gy). ORN healed in only one patient after 32 months of treatment with repeated debridement and topical betamethasone cream. Conclusion: Extra-mandibular ORN is a rare late toxicity and this current study provides useful information on its incidence and outcome. The risk of temporal bone ORN should be considered in the treatment of parotid malignancies and patients should be counselled. More research is required to determine the optimal management of extra-mandibular ORN, particularly on the role of the PENTOCLO regimen.
Author(s): Kovarik PDE, Patil R, Cvek J, Kelly C, Jackson M, Mackenzie L, West N, Willis N, Kovarik JP, Banks R, Kennedy M, Adams J, Iqbal MS
Publication type: Article
Publication status: Published
Journal: Clinical Oncology
Year: 2023
Volume: 35
Issue: 9
Pages: e498-e505
Print publication date: 01/09/2023
Online publication date: 27/06/2023
Acceptance date: 02/04/2018
ISSN (print): 0936-6555
ISSN (electronic): 1433-2981
Publisher: Elsevier Ltd
URL: https://doi.org/10.1016/j.clon.2023.06.013
DOI: 10.1016/j.clon.2023.06.013
PubMed id: 37433701
Altmetrics provided by Altmetric