ArticleHead & neck2026
Incidence and Site-Specific Risk Factors of Jaw Osteoradionecrosis for Head and Neck Patients in the IMRT/VMAT Era: Evidence From a Large, Hospital-Based Cohort.
Article in Head & neck, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeOsteoradionecrosis (ORN) of the jaw remains a serious late complication of head and neck cancer (HNC) radiotherapy. Although intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc radiotherapy (VMAT) are expected to reduce ORN risk, large real-world data in the modern era are limited. This study evaluated the incidence, latency, and risk factors of ORN across radiotherapy modalities in a large hospital-based cohort. MATERIALS AND
methodsWe retrospectively analyzed 6199 patients with HNC treated with curative radiotherapy between 2006 and 2020. ORN was defined as exposed necrotic jaw bone persisting for > 3 months without tumor recurrence. ORN incidence was compared between conventional 2D/3D radiotherapy and IMRT/VMAT. Latency to ORN onset was assessed using Kaplan-Meier analysis, and independent predictors were identified using multivariate Cox regression for demographic, tumor-related, treatment-related, and patient-related variables.
resultsOverall, 278 patients (4.5%) developed ORN. The incidence was 5.5% after 2D/3D radiotherapy and 4.4% after IMRT/VMAT, without a significant overall difference. However, IMRT/VMAT significantly reduced ORN risk in nasopharyngeal carcinoma (NPC) (1.6% vs. 5.4%, p = 0.006). ORN incidence was highest in oral cavity cancers (7.9%), particularly gingival and floor-of-mouth subsites. Median latency to ORN onset was 24 months (interquartile range 12-44) and was longer after IMRT/VMAT than after 2D/3D radiotherapy (26 vs. 18 months, p = 0.021). Multivariate analysis identified non-NPC diagnosis (adjusted hazard ratio [aHR] 2.71), advanced clinical stage (aHR 1.66), dental extraction (aHR 3.21), adverse oral habits (aHR 1.45), and abnormal body mass index (aHR 1.45) as independent predictors of ORN (all p < 0.05).
conclusionIn this large contemporary cohort, ORN occurred in 4.5% of HNC patients after radiotherapy. IMRT/VMAT reduced ORN risk and delayed onset, particularly in NPC. Tumor site, disease stage, dental extraction, oral habits, and nutritional status remain key determinants, underscoring the importance of individualized risk stratification and preventive dental care in the IMRT/VMAT era.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.