ArticleHead & face medicine2022
Frequency of osteoradionecrosis of the lower jaw after radiotherapy of oral cancer patients correlated with dosimetric parameters and other risk factors.
Article in Head & face medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Identifying risk factors for osteoradionecrosis of the jaws: a systematic review and meta-analysis.Clinical oral investigations · 2026Pooled it
- Periodontal Disease and Risk of Osteoradionecrosis in Patients with Head and Neck Cancer Undergoing Radiotherapy: A Systematic Review and Meta-Analysis.Dentistry journal · 2026Review
- Multi-institutional Normal Tissue Complication Probability (NTCP) Prediction Model for Mandibular Osteoradionecrosis: Results from the PREDMORN Study.International journal of radiation oncology, biology, physics · 2026Article
- Osteoradionecrosis After Modern Radiotherapy for Oral Cavity Cancer: Incidence and Risk Factors.Laryngoscope investigative otolaryngology · 2026Article
- From Diagnosis to Behaviour Change: Applying the Health Action Process Approach to Smoking Cessation After Head and Neck Cancer.Behavioral sciences (Basel, Switzerland) · 2026Article
- Predicting Difficult Tracheal Intubation in Head and Neck Cancer Patients with Osteoradionecrosis: Development of the ORN-Difficult-Airway-Score.Medical sciences (Basel, Switzerland) · 2026Article
- Decoding Osteoradionecrosis of the Jaw: Radiological Progression and a Novel CT-Based Grading System.Cancers · 2026Article
- Externally validated digital decision support tool for time-to-osteoradionecrosis risk-stratification using right-censored multi-institutional observational cohorts.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2025Observational
- Predictive modelling of mandibular osteoradionecrosis in head and neck cancer patients: clinical and dosimetric insights.Clinical oral investigations · 2025Article
- Prevention of osteoradionecrosis in patients with head and neck cancer treated with radiation therapy.Head & neck · 2025Article
- Mandibular dose-volume predicts time-to-osteoradionecrosis in an actuarial normal-tissue complication probability (NTCP) model: External validation of right-censored clinico-dosimetric and competing risk application across international multi-institutional observational cohorts and online graphical user interface clinical support tool assessment.medRxiv : the preprint server for health sciences · 2024Article
- Risk factor analysis and development of predictive models for osteoradionecrosis in patients with nasopharyngeal carcinoma after concurrent chemoradiotherapy.American journal of cancer research · 2024Article
- Review of Osteoradionecrosis of the Jaw: Radiotherapy Modality, Technique, and Dose as Risk Factors.Journal of clinical medicine · 2023Review
- Unforeseen Outcomes Post Treatment for Radiation Induced Trismus: A Case Report.Medicines (Basel, Switzerland) · 2022Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesOsteoradionecrosis (ORN) of the lower jaw is a serious late complication after radiotherapy in patients with oral cavity cancer. The aim of this study is to generate more insight into which patient- and treatment-related factors are associated with the development of ORN in oral cavity cancer patients undergoing postoperative radiotherapy. MATERIAL AND
methodsRetrospective evaluation and comparison of 44 patients with ORN (event group 1) matched according to 45 patients without ORN (control group 2) who received postoperative radiotherapy of oral cavity squamous cell carcinoma at our institution between 2012 and 2020. Dosimetric factors that favor the occurrence of ORN should be detected. The cumulative occurrence rate of ORN was calculated according to the Kaplan-Meier method and analyzed by Cox regression and log-rank test.
resultsThe median time to develop ORN was 18 months (3-93 months) after radiotherapy. Dental status before radiotherapy (RT) treatment (HR 4.5; 1.8-11.5) and dosimetric parameters including Dmean > 45 Gy (HR 2.4; 1.0-5.7), Dmax > 60 Gy (HR 1.3; 1.1-2.8) and planning target volume (PTV) proportion > 40% intersection with the lower jaw (HR 1.1; 1.0-1.1) were significantly associated with ORN.
conclusionThe results of this retrospective study reveal that oral cavity cancer patients who underwent pre-RT dental surgery as well as dosimetric parameters using Dmax > 60 Gy, higher mean doses > 45 Gy and more than 40% PTV intersection with the lower jaw bone are independent risk factors for ORN. These findings can assist in the management of patients undergoing RT for head and neck cancer regarding ORN prevention. CLINICAL RELEVANCE: Poor oral hygiene and desolate dental status as well as high radiation doses to the mandibular bone significantly increase the risk of developing osteoradionecrosis. Before irradiating a patient with oral cavity cancer, an appointment with the dentist should be made and teeth sanitized if necessary. Likewise, maximum radiation doses to the lower jaw should be minimized.
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