Incidence of mandibular osteoradionecrosis (MORN) after intensity modulated radiotherapy (IMRT) versus 3D conformal radiotherapy (3D-CRT): A systematic review

BACKGROUND: Analyze the incidence of MORN after head and neck radiotherapy by two novel irradiation techniques, 3DCRT and IMRT and compare the success rates of distinct authors. MATERIAL AND METHODS: An electronic search in Pubmed (MEDLINE), Ovid, Google Scholar and Cochrane Library (Wiley), databases was conducted with the key words "Radiotherapy, Conformal"[Mesh] OR "Radiotherapy, Intensity-Modulated"[Mesh]) AND "Osteoradionecrosis"[Mesh] for all databases. The inclusion criteria randomized controlled trials (RCT), as well as prospective and retrospective cohort studies published in English; MORN patients treated with 3D-CRT y IMRT. RESULTS: 27 articles were selected from 194 initially found. 14 articles out of 27 were excluded and finally included 8 publications were included in the systematic review that were ranked according to their level of scientific evidence using the SORT criteria. CONCLUSIONS: When both RT techniques were compared; IMRT revealed a lower risk incidence of MORN development and enhanced dose constraint than 3D-CRT (less than 10%), this improvement could translate into less complications post RT treatment. Key words:Radiotherapy, conformal, intensity-modulated, osteoradionecrosis.