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Three-dimensional (3D) anatomic location, extension, and timing of severe osteoradionecrosis of the mandible
BACKGROUND: The purpose of this study was to describe the topography, extension (volume), and timing of severe osteoradionecrosis (ORN) that required mandible resection in patients previously treated for head and neck cancer at a high-volume Veterans Affairs Medical Center. MATERIALS AND METHODS: Th...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Via Medica
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9518768/ https://www.ncbi.nlm.nih.gov/pubmed/36186684 http://dx.doi.org/10.5603/RPOR.a2022.0057 |
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author | Sapienza, Lucas G. Thomas, Justin J. Mai, Weiyuan Hanania, Alexander N. Hunjan, Sandeep Sandulache, Vlad C. Chen, Albert C. |
author_facet | Sapienza, Lucas G. Thomas, Justin J. Mai, Weiyuan Hanania, Alexander N. Hunjan, Sandeep Sandulache, Vlad C. Chen, Albert C. |
author_sort | Sapienza, Lucas G. |
collection | PubMed |
description | BACKGROUND: The purpose of this study was to describe the topography, extension (volume), and timing of severe osteoradionecrosis (ORN) that required mandible resection in patients previously treated for head and neck cancer at a high-volume Veterans Affairs Medical Center. MATERIALS AND METHODS: The records from a reference hyperbaric oxygen clinic were retrospectively analyzed (n = 50, 2018–2021). Inclusion criteria were: I) severe ORN defined as progressive ORN that required resection; II) pathologic confirmation of ORN; and III) availability of pre-operative CT-imaging. Using a radiotherapy (RT) imaging software, we performed a detailed volumetric (3D) analysis of the bone involvement by ORN. Time intervals from RT to surgery for ORN and from surgery to the last follow-up were calculated. RESULTS: All patients that met inclusion criteria (n = 10) were male with significant smoking history (median 47.5 pack-years) and a median age of 57 years old at the time of RT. The primary tumors were: oropharynx (n = 6), oral cavity (n = 3) and nasopharynx (n = 1). The median time from RT to ORN surgery was 8 years. The most common ORN location was the posterior lateral body (molar) and six patients had associated fractures. The mean ORN volume was 3.6 cc (range: 0.6–8.3), corresponding to a mean 6.3% (range: 0.7–14) of the total mandibular volume. After a median follow-up of 13.5 months, no recurrence of ORN occurred. Three patients died of non-cancer and non-ORN-recurrence related causes (1 y OS 77.1%). CONCLUSION: Severe ORN occurred after a median of 8 years from the previous RT and usually affected the posterior lateral body. Surgical resection achieved excellent ORN control. |
format | Online Article Text |
id | pubmed-9518768 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Via Medica |
record_format | MEDLINE/PubMed |
spelling | pubmed-95187682022-09-29 Three-dimensional (3D) anatomic location, extension, and timing of severe osteoradionecrosis of the mandible Sapienza, Lucas G. Thomas, Justin J. Mai, Weiyuan Hanania, Alexander N. Hunjan, Sandeep Sandulache, Vlad C. Chen, Albert C. Rep Pract Oncol Radiother Research Paper BACKGROUND: The purpose of this study was to describe the topography, extension (volume), and timing of severe osteoradionecrosis (ORN) that required mandible resection in patients previously treated for head and neck cancer at a high-volume Veterans Affairs Medical Center. MATERIALS AND METHODS: The records from a reference hyperbaric oxygen clinic were retrospectively analyzed (n = 50, 2018–2021). Inclusion criteria were: I) severe ORN defined as progressive ORN that required resection; II) pathologic confirmation of ORN; and III) availability of pre-operative CT-imaging. Using a radiotherapy (RT) imaging software, we performed a detailed volumetric (3D) analysis of the bone involvement by ORN. Time intervals from RT to surgery for ORN and from surgery to the last follow-up were calculated. RESULTS: All patients that met inclusion criteria (n = 10) were male with significant smoking history (median 47.5 pack-years) and a median age of 57 years old at the time of RT. The primary tumors were: oropharynx (n = 6), oral cavity (n = 3) and nasopharynx (n = 1). The median time from RT to ORN surgery was 8 years. The most common ORN location was the posterior lateral body (molar) and six patients had associated fractures. The mean ORN volume was 3.6 cc (range: 0.6–8.3), corresponding to a mean 6.3% (range: 0.7–14) of the total mandibular volume. After a median follow-up of 13.5 months, no recurrence of ORN occurred. Three patients died of non-cancer and non-ORN-recurrence related causes (1 y OS 77.1%). CONCLUSION: Severe ORN occurred after a median of 8 years from the previous RT and usually affected the posterior lateral body. Surgical resection achieved excellent ORN control. Via Medica 2022-07-29 /pmc/articles/PMC9518768/ /pubmed/36186684 http://dx.doi.org/10.5603/RPOR.a2022.0057 Text en © 2022 Greater Poland Cancer Centre https://creativecommons.org/licenses/by-nc-nd/4.0/This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially |
spellingShingle | Research Paper Sapienza, Lucas G. Thomas, Justin J. Mai, Weiyuan Hanania, Alexander N. Hunjan, Sandeep Sandulache, Vlad C. Chen, Albert C. Three-dimensional (3D) anatomic location, extension, and timing of severe osteoradionecrosis of the mandible |
title | Three-dimensional (3D) anatomic location, extension, and timing of severe osteoradionecrosis of the mandible |
title_full | Three-dimensional (3D) anatomic location, extension, and timing of severe osteoradionecrosis of the mandible |
title_fullStr | Three-dimensional (3D) anatomic location, extension, and timing of severe osteoradionecrosis of the mandible |
title_full_unstemmed | Three-dimensional (3D) anatomic location, extension, and timing of severe osteoradionecrosis of the mandible |
title_short | Three-dimensional (3D) anatomic location, extension, and timing of severe osteoradionecrosis of the mandible |
title_sort | three-dimensional (3d) anatomic location, extension, and timing of severe osteoradionecrosis of the mandible |
topic | Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9518768/ https://www.ncbi.nlm.nih.gov/pubmed/36186684 http://dx.doi.org/10.5603/RPOR.a2022.0057 |
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