Potential risk factors for jaw osteoradionecrosis after radiotherapy for head and neck cancer
Identifieur interne : 000599 ( Main/Exploration ); précédent : 000598; suivant : 000600Potential risk factors for jaw osteoradionecrosis after radiotherapy for head and neck cancer
Auteurs : Thomas Kuhnt [Allemagne] ; Andreas Stang [Allemagne] ; Andreas Wienke [Allemagne] ; Dirk Vordermark [Allemagne] ; Ramona Schweyen [Allemagne] ; Jeremias Hey [Allemagne]Source :
- Radiation Oncology (London, England) [ 1748-717X ] ; 2016.
Abstract
To identify potential risk factors for the development of jaw osteoradionecrosis (ORN) after 3D-conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) among patients with newly diagnosed head and neck cancer.
This study included 776 patients who underwent 3D-CRT or IMRT for head and neck cancer at the Department of Radiotherapy at the University Hospital Halle-Wittenberg between 2003 and 2013. Sex, dental status prior to radiotherapy, tumor site, bone surgery during tumor resection, concomitant chemotherapy, and the development of advanced ORN were documented for each patient. ORN was classified as grade 3, 4, or 5 according to the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer classification or grade 3 or 4 according to the late effects in normal tissues/subjective, objective, management, and analytic scale. The cumulative incidence of ORN was estimated. Cox regression analysis was used to identify prognostic risk factors for the development of ORN.
Fifty-one patients developed advanced ORN (relative frequency 6.6 %, cumulative incidence 12.4 %). The highest risk was found in patients who had undergone primary bone surgery during tumor resection (hazard ratio [HR] = 5.87; 95 % confidence interval [CI]: 3.09–11.19) and in patients with tumors located in the oral cavity (HR = 4.69; 95 % CI: 1.33–16.52). Sex, dentition (dentulous vs. edentulous), and chemotherapy had no clinically relevant influence.
In contrast to most previous studies, we noted a low cumulative incidence of advanced ORN. Patients with tumors located in the oral cavity and those who undergo bone surgery during tumor resection prior to RT may be considered a high-risk group for the development of ORN.
Url:
DOI: 10.1186/s13014-016-0679-6
PubMed: 27473433
PubMed Central: 4967325
Affiliations:
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type="district" nuts="2">District de Leipzig</region><settlement type="city">Leipzig</settlement></placeName></affiliation></author><author><name sortKey="Stang, Andreas" sort="Stang, Andreas" uniqKey="Stang A" first="Andreas" last="Stang">Andreas Stang</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Medical Informatics, Biometry and Epidemiology, University Clinic Essen, Essen, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Medical Informatics, Biometry and Epidemiology, University Clinic Essen, Essen</wicri:regionArea><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion><wicri:noRegion>Essen</wicri:noRegion></affiliation></author><author><name sortKey="Wienke, Andreas" sort="Wienke, Andreas" uniqKey="Wienke A" first="Andreas" last="Wienke">Andreas Wienke</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Medical Epidemiology, Biometry and Computer Science Martin-Luther-University Halle-Wittenberg, Halle, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Medical Epidemiology, Biometry and Computer Science Martin-Luther-University Halle-Wittenberg, Halle</wicri:regionArea><wicri:noRegion>Halle</wicri:noRegion><wicri:noRegion>Halle</wicri:noRegion><wicri:noRegion>Halle</wicri:noRegion></affiliation></author><author><name sortKey="Vordermark, Dirk" sort="Vordermark, Dirk" uniqKey="Vordermark D" first="Dirk" last="Vordermark">Dirk Vordermark</name><affiliation wicri:level="1"><nlm:aff id="Aff4">Department of Radiotherapy, University Clinic, Martin-Luther-University Halle-Wittenberg, Halle, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Radiotherapy, University Clinic, Martin-Luther-University Halle-Wittenberg, Halle</wicri:regionArea><wicri:noRegion>Halle</wicri:noRegion><wicri:noRegion>Halle</wicri:noRegion><wicri:noRegion>Halle</wicri:noRegion></affiliation></author><author><name sortKey="Schweyen, Ramona" sort="Schweyen, Ramona" uniqKey="Schweyen R" first="Ramona" last="Schweyen">Ramona Schweyen</name><affiliation wicri:level="1"><nlm:aff id="Aff5">Department of Prosthetic Dentistry, University School of Dental Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Prosthetic Dentistry, University School of Dental Medicine, Martin-Luther-University Halle-Wittenberg, Halle</wicri:regionArea><wicri:noRegion>Halle</wicri:noRegion><wicri:noRegion>Halle</wicri:noRegion><wicri:noRegion>Halle</wicri:noRegion></affiliation></author><author><name sortKey="Hey, Jeremias" sort="Hey, Jeremias" uniqKey="Hey J" first="Jeremias" last="Hey">Jeremias Hey</name><affiliation wicri:level="1"><nlm:aff id="Aff5">Department of Prosthetic Dentistry, University School of Dental Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Prosthetic Dentistry, University School of Dental Medicine, Martin-Luther-University Halle-Wittenberg, Halle</wicri:regionArea><wicri:noRegion>Halle</wicri:noRegion><wicri:noRegion>Halle</wicri:noRegion><wicri:noRegion>Halle</wicri:noRegion></affiliation></author></analytic><series><title level="j">Radiation Oncology (London, England)</title><idno type="eISSN">1748-717X</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>To identify potential risk factors for the development of jaw osteoradionecrosis (ORN) after 3D-conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) among patients with newly diagnosed head and neck cancer.</p></sec><sec><title>Material and methods</title><p>This study included 776 patients who underwent 3D-CRT or IMRT for head and neck cancer at the Department of Radiotherapy at the University Hospital Halle-Wittenberg between 2003 and 2013. Sex, dental status prior to radiotherapy, tumor site, bone surgery during tumor resection, concomitant chemotherapy, and the development of advanced ORN were documented for each patient. ORN was classified as grade 3, 4, or 5 according to the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer classification or grade 3 or 4 according to the late effects in normal tissues/subjective, objective, management, and analytic scale. The cumulative incidence of ORN was estimated. Cox regression analysis was used to identify prognostic risk factors for the development of ORN.</p></sec><sec><title>Results</title><p>Fifty-one patients developed advanced ORN (relative frequency 6.6 %, cumulative incidence 12.4 %). The highest risk was found in patients who had undergone primary bone surgery during tumor resection (hazard ratio [HR] = 5.87; 95 % confidence interval [CI]: 3.09–11.19) and in patients with tumors located in the oral cavity (HR = 4.69; 95 % CI: 1.33–16.52). Sex, dentition (dentulous vs. edentulous), and chemotherapy had no clinically relevant influence.</p></sec><sec><title>Discussion and conclusion</title><p>In contrast to most previous studies, we noted a low cumulative incidence of advanced ORN. 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Munroe</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Allemagne</li></country><region><li>District de Leipzig</li><li>Saxe (Land)</li></region><settlement><li>Leipzig</li></settlement></list><tree><country name="Allemagne"><region name="Saxe (Land)"><name sortKey="Kuhnt, Thomas" sort="Kuhnt, Thomas" uniqKey="Kuhnt T" first="Thomas" last="Kuhnt">Thomas Kuhnt</name></region><name sortKey="Hey, Jeremias" sort="Hey, Jeremias" uniqKey="Hey J" first="Jeremias" last="Hey">Jeremias Hey</name><name sortKey="Schweyen, Ramona" sort="Schweyen, Ramona" uniqKey="Schweyen R" first="Ramona" last="Schweyen">Ramona Schweyen</name><name sortKey="Stang, Andreas" sort="Stang, Andreas" uniqKey="Stang A" first="Andreas" last="Stang">Andreas Stang</name><name sortKey="Vordermark, Dirk" sort="Vordermark, Dirk" uniqKey="Vordermark D" first="Dirk" last="Vordermark">Dirk Vordermark</name><name sortKey="Wienke, Andreas" sort="Wienke, Andreas" uniqKey="Wienke A" first="Andreas" last="Wienke">Andreas Wienke</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:27473433" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a EdenteV2
| This area was generated with Dilib version V0.6.32. |  |