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Lookup NU author(s): Nick West
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© 2024. Purpose: Osteoradionecrosis of the jaw (ORNJ) is a severe iatrogenic disease characterized by bone death after radiation therapy to the head and neck. With >9 published definitions and at least 16 classification systems, the true incidence and severity of ORNJ are obscured by lack of a standard for disease definition and severity assessment, leading to inaccurate estimation of incidence, reporting ambiguity, and likely underdiagnosis worldwide. This study aimed to achieve consensus on an explicit definition and phenotype of ORNJ and related precursor states through data standardization to facilitate effective diagnosis, monitoring, and multidisciplinary management of ORNJ. Methods and Materials: The Orodental Radiotherapy-Associated Late-Effects Consortium comprised 69 international experts, including representatives from medical, surgical, radiation oncology, and oral/dental disciplines. Using a web-based modified Delphi technique, panelists classified descriptive cases using existing classification systems, reviewed systems for feature extraction and specification, and iteratively classified cases based on clinical/imaging feature combinations. Results: The Consortium ORNJ definition was developed in alignment with Systematized Nomenclature of Medicine - Clinical Terms (SNOMED-CT) terminology and recent International Society of Oral Oncology-Multinational Association for Supportive Care in Cancer and the American Society of Clinical Oncology (ISOO-MASCC-ASCO) guideline recommendations. Case review using existing ORNJ classification systems showed high rates of inability to classify (up to 76%). Ten consensus statements and 9 minimum data elements (MDEs) were outlined for prospective collection and classification of precursor/ORNJ disease states. Conclusions: This study provides an international, consensus-based definition and MDE foundation for standardized ORNJ reporting in cancer survivors treated with radiation therapy. Head and neck surgeons, radiation, surgical, medical oncologists, and dental specialists should adopt MDEs to enable scalable health information exchange and analytics. Work is underway to develop both a human- and machine-readable knowledge representation for ORNJ (ie, ontology) and multidisciplinary resources for dissemination to improve ORNJ reporting in academic and community practice settings.
Author(s): Moreno AC, Watson EE, Humbert-Vidan L, Peterson DE, van Dijk LV, Urbano TG, Bosch LVD, Hope AJ, Katz MS, Hoebers FJP, Wesson RAA, Bates JE, Bossi P, Dayo AF, Dore M, Fregnani ER, Galloway TJ, Gelblum DY, Hanna IA, Henson CE, Kiat-amnuay S, Korfage A, Lee NY, Lewis CM, Lynggaard CD, Makitie AA, Magalhaes M, Mowery YM, Munoz-Montplet C, Myers JN, Orlandi E, Patel J, Rigert JM, Saunders D, Schoenfeld JD, Selek U, Somay E, Takiar V, Thariat J, Verduijn GM, Villa A, West NS, Witjes MJH, Won AM, Wong ME, Yao CMKL, Young SW, Al-eryani K, Barbon CEA, Buurman DJM, Dieleman FJ, Hofstede TM, Khan AA, Otun AO, Robinson JC, Hum L, Johansen J, Lalla R, Lin A, Patel V, Shaw RJ, Chambers MS, Ma D, Singh M, Yarom N, Mohamed ASR, Hutcheson KA, Lai SY, Fuller CD
Publication type: Article
Publication status: Published
Journal: International Journal of Radiation Oncology Biology Physics
Year: 2025
Pages: Epub ahead of print
Online publication date: 16/01/2025
Acceptance date: 22/12/2024
ISSN (print): 0360-3016
ISSN (electronic): 1879-355X
Publisher: Elsevier Inc.
URL: https://doi.org/10.1016/j.ijrobp.2024.12.017
DOI: 10.1016/j.ijrobp.2024.12.017
PubMed id: 39826846
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