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Risk factors and dose-effect relationship for mandibular osteoradionecrosis in oral and oropharyngeal cancer patients

Authors
 IK JAE LEE  ;  WOONG SUB KOOM  ;  CHANG GEOL LEE  ;  YONG BAE KIM  ;  SEI WHAN YOO  ;  KI CHANG KEUM  ;  GWI EON KIM  ;  EUN CHANG CHOI  ;  IN HO CHA 
Citation
 International Journal of Radiation Oncology Biology Physics, Vol.75(4) : 1084-1091, 2009 
Journal Title
 International Journal of Radiation Oncology Biology Physics 
ISSN
 0360-3016 
Issue Date
2009
MeSH
Adult ; Aged ; Aged, 80 and over ; Analysis of Variance ; Dose-Response Relationship, Radiation ; Female ; Humans ; Male ; Mandible/surgery ; Mandibular Diseases/etiology* ; Middle Aged ; Mouth Neoplasms/radiotherapy* ; Mouth Neoplasms/surgery ; Oropharyngeal Neoplasms/radiotherapy* ; Oropharyngeal Neoplasms/surgery ; Osteoradionecrosis/etiology* ; Postoperative Complications ; Radiotherapy Dosage ; Regression Analysis ; Relative Biological Effectiveness ; Retrospective Studies ; Risk Factors ; Young Adult
Abstract
PURPOSE: To analyze risk factors and the dose-effect relationship for osteoradionecrosis (ORN) of the mandible after radiotherapy of oral and oropharyngeal cancers. MATERIALS and METHODS: One-hundred ninety-eight patients with oral (45%) and oropharyngeal cancer (55%) who had received external radiotherapy between 1990 and 2000 were retrospectively reviewed. All patients had a dental evaluation before radiotherapy. the median radiation dose was 60 Gy (range, 16-75 Gy), and the median biologically effective dose for late effects (BED(late)) in bone was 114 Gy(2) (range, 30-167 Gy(2)). RESULTS: the frequency of ORN was 13 patients (6.6%). Among patients with mandibular surgery, eight had ORN at the surgical site. Among patients without mandibular surgery, five patients had ORN on the molar area of the mandible. the median time to ORN was 22 months (range, 1-69 months). Univariate analysis revealed that mandibular surgery and Co-60 were significant risk factors for ORN (p = 0.01 and 0.04, respectively). in multivariate analysis, mandibular surgery was the most important factor (p = 0.001). High radiation doses over BED 102.6 Gy(2) (conventional dose of 54 Gy at 1.8 Gy/fraction) were also a significant factor for ORN (p = 0.008) and showed a positive dose-effect relationship in logistic regression (p = 0.04) for patients who had undergone mandibular surgery. CONCLUSIONS: Mandibular surgery was the most significant risk factor for ORN of mandible in oral and oropharyngeal cancers patients. A BED of 102.6 Gy(2) or higher to the mandible also significantly increases the risk of ORN.
Full Text
http://www.sciencedirect.com/science/article/pii/S0360301609000108
DOI
10.1016/j.ijrobp.2008.12.052
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Oral and Maxillofacial Surgery (구강악안면외과학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
Kim, Gwi Eon(김귀언)
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
Cha, In Ho(차인호) ORCID logo https://orcid.org/0000-0001-8259-2190
Choi, Eun Chang(최은창)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/105634
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