388 Radiation necrosis of the mandible after radiotherapy of 921 oropharynx and oral cavity carcinomas
Identifieur interne : 00A837 ( Main/Exploration ); précédent : 00A836; suivant : 00A838388 Radiation necrosis of the mandible after radiotherapy of 921 oropharynx and oral cavity carcinomas
Auteurs : G. Calais [France] ; S. Chapet [France] ; C. Berger [France] ; A. Reynaud-Bougnoux [France] ; O. Le Floch [France]Source :
- European Journal of Cancer [ 0959-8049 ] ; 1995.
English descriptors
- KwdEn :
- Carcinoma, Effective dose, Local control, Local tumour control rates, Multivariate analysis, Neck cancer, Nodal involvement, Overall treatment time, Radiotherapy, Randomized, Regional control, Supraglottic, Supraglottic region, Surgical resection, Total dose, Total treatment time, Treatment delays, Tumour.
- Teeft :
- Carcinoma, Effective dose, Local control, Local tumour control rates, Multivariate analysis, Neck cancer, Nodal involvement, Overall treatment time, Radiotherapy, Randomized, Regional control, Supraglottic, Supraglottic region, Surgical resection, Total dose, Total treatment time, Treatment delays, Tumour.
Abstract
With megavoltage radiotherapy (RT) incidence of bone radiation necrosis of the mandible (BRN) has been decreased, but it is still a serious complication. The purpose of this study was to evaluate over a 15 year period of time, incidence and predictive factors of BRN after treatment of 921 carcinomas of the oropharynx and oral cavity.The mean age was 58.3 years. 881 were male and 40 female. RT technique was homogeneous using to lateral opposed fields treated at each session. 815 patients (pts) were treated using a Cobalt 60 unit and 46 with 10 Mv photons. Total dose ranged from 40 to 82Gy (mean dose of 68Gy). Dose per fraction ranged from 1.8 to 5.0Gy. For 67 pts a boost was delivered with brachytherapy. 321 pts received chemotherapy (neoadjuvant or concomitant). For 210 pts surgical resection of the tumor was performed before RT 303 pts were toothless, the others received fluoride applications.60 patients (6.5%) developed BRN with a mean delay of appearance of 12.3 months (5 to 63). Surgical resection of the mandible was neces-sary for 28 patients (46%). Uni and multivariate analysis showed that factors associated with a high incidence of BRN were a total dose over 70Gy, a dose per fraction >3Gy, a boost given with brachytherapy and a combination of surgery and radiotherapy.We concluded that BRN is rare complication but incidence could be decreased with optimisation of technical parameters of radiation therapy.
Url:
DOI: 10.1016/0959-8049(95)95641-I
Affiliations:
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Le Floch</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Clinique dOncologie et Radiothrapie, Centre Hospitalier Universitaire, 37044 Tours</wicri:regionArea><placeName><region type="region" nuts="2">Centre-Val de Loire</region><region type="old region" nuts="2">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">European Journal of Cancer</title><title level="j" type="abbrev">EJC</title><idno type="ISSN">0959-8049</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1995">1995</date><biblScope unit="volume">31</biblScope><biblScope unit="supplement">S6</biblScope><biblScope unit="page" from="S85">S85</biblScope></imprint><idno type="ISSN">0959-8049</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0959-8049</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Carcinoma</term><term>Effective dose</term><term>Local control</term><term>Local tumour control rates</term><term>Multivariate analysis</term><term>Neck cancer</term><term>Nodal involvement</term><term>Overall treatment time</term><term>Radiotherapy</term><term>Randomized</term><term>Regional control</term><term>Supraglottic</term><term>Supraglottic region</term><term>Surgical resection</term><term>Total dose</term><term>Total treatment time</term><term>Treatment delays</term><term>Tumour</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Carcinoma</term><term>Effective dose</term><term>Local control</term><term>Local tumour control rates</term><term>Multivariate analysis</term><term>Neck cancer</term><term>Nodal involvement</term><term>Overall treatment time</term><term>Radiotherapy</term><term>Randomized</term><term>Regional control</term><term>Supraglottic</term><term>Supraglottic region</term><term>Surgical resection</term><term>Total dose</term><term>Total treatment time</term><term>Treatment delays</term><term>Tumour</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">With megavoltage radiotherapy (RT) incidence of bone radiation necrosis of the mandible (BRN) has been decreased, but it is still a serious complication. The purpose of this study was to evaluate over a 15 year period of time, incidence and predictive factors of BRN after treatment of 921 carcinomas of the oropharynx and oral cavity.The mean age was 58.3 years. 881 were male and 40 female. RT technique was homogeneous using to lateral opposed fields treated at each session. 815 patients (pts) were treated using a Cobalt 60 unit and 46 with 10 Mv photons. Total dose ranged from 40 to 82Gy (mean dose of 68Gy). Dose per fraction ranged from 1.8 to 5.0Gy. For 67 pts a boost was delivered with brachytherapy. 321 pts received chemotherapy (neoadjuvant or concomitant). For 210 pts surgical resection of the tumor was performed before RT 303 pts were toothless, the others received fluoride applications.60 patients (6.5%) developed BRN with a mean delay of appearance of 12.3 months (5 to 63). Surgical resection of the mandible was neces-sary for 28 patients (46%). Uni and multivariate analysis showed that factors associated with a high incidence of BRN were a total dose over 70Gy, a dose per fraction >3Gy, a boost given with brachytherapy and a combination of surgery and radiotherapy.We concluded that BRN is rare complication but incidence could be decreased with optimisation of technical parameters of radiation therapy.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Centre-Val de Loire</li><li>Région Centre</li></region><settlement><li>Tours</li></settlement></list><tree><country name="France"><region name="Centre-Val de Loire"><name sortKey="Calais, G" sort="Calais, G" uniqKey="Calais G" first="G." last="Calais">G. Calais</name></region><name sortKey="Berger, C" sort="Berger, C" uniqKey="Berger C" first="C." last="Berger">C. Berger</name><name sortKey="Chapet, S" sort="Chapet, S" uniqKey="Chapet S" first="S." last="Chapet">S. Chapet</name><name sortKey="Le Floch, O" sort="Le Floch, O" uniqKey="Le Floch O" first="O." last="Le Floch">O. Le Floch</name><name sortKey="Reynaud Bougnoux, A" sort="Reynaud Bougnoux, A" uniqKey="Reynaud Bougnoux A" first="A." last="Reynaud-Bougnoux">A. Reynaud-Bougnoux</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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