ArticleClinical oral investigations2025
Predictive modelling of mandibular osteoradionecrosis in head and neck cancer patients: clinical and dosimetric insights.
Article in Clinical oral investigations, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prognostic value of sarcopenia in patients with nasopharyngeal carcinoma: a meta-analysis.Annals of medicine · 2025Pooled it
- Personalized Prevention of Osteoradionecrosis of the Jaws: From Clinical Risk Profiling and Site-Specific Dosimetry to Artificial Intelligence and Individualized Treatment-Effect Estimation.Journal of personalized medicine · 2026Review
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5 authors.
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Abstract
introductionMandibular osteoradionecrosis (ORN) is a serious complication of radiotherapy (RT) for head and neck cancer (HNC), with an incidence of 3-15%. ORN results from radiation-induced bone necrosis and may require surgical intervention. This study investigates clinical and dosimetric predictors of ORN risk and develops a predictive model for individualized risk assessment. MATERIALS AND
methodsThis retrospective case-control study included 298 HNC patients treated with RT or chemoradiotherapy between January 2012 and May 2020. Dosimetric parameters, including mandibular V10-V60, mean dose (Dmean), and maximum dose (Dmax), were analyzed alongside clinical data such as age, tumor site, smoking history, and dental extractions.
resultsOver a median follow-up of 32.4 months, 20 patients (6.7%) developed ORN, with a 5-year cumulative incidence of 7.4%. Multivariate analysis identified mandibular V50 (HR = 1.05, p = 0.0015) and post-RT dental extractions (HR = 2.51, p < 0.0001) as significant ORN risk factors, while age was protective (HR = 0.96, p = 0.047). A V50 cutoff of 25.4 cm³ was most predictive (p = 0.0016). The multivariate model incorporating V50, age, and dental extractions demonstrated strong accuracy (C-index: 0.815, AUC: 0.8).
conclusionV50 and post-RT dental extractions are key predictors of ORN. The developed nomogram enables personalized risk assessment, supporting treatment optimization. These findings emphasize the need for tailored RT planning and dental care to mitigate ORN risk, warranting validation in multi-institutional cohorts.
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