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Research Articles

Long-term follow-up of osteoradionecrosis of the mandible

, , , &
Pages 48-54 | Received 01 Mar 2023, Accepted 05 Sep 2023, Published online: 29 Sep 2023
 

Abstract

Aim

Investigating the prevalence of mandibular ORN in a single Swedish Oncology Center.

Methods

A total of 450 patients, treated with radiotherapy for squamous cell carcinoma in the oropharynx between 2004 and 2014 were included. Three different techniques of radiotherapy were studied. ORN diagnosis was set when clinical signs according to Marx were observed, or if radiological signs were staged according to Schwartz and Kagan.

Results

Using the staging system, 90 patients (20%) were diagnosed with ORN. The mean age of the ORN patients was 56.6 years, the older the patient the lower the risk of developing ORN (p = .01). The risk of developing ORN for patients receiving Intensity Modulated Radiotherapy was lower compared to patients treated with the other techniques in the multivariable analysis. Brachytherapy significantly increases the risk of ORN. The risk of ORN increased by 8% each year after radiation (p = .04). The mean time to the ORN diagnosis was 3.9 years. In the multivariate analysis, the risk of ORN increased by 13% each year after radiation (p = .0013).

Conclusion

The mean radiation dose was of greater importance for the risk of ORN than the maximum dose. Elderly people with oropharyngeal cancer were less prone to develop ORN.

Acknowledgements

This research was supported by the Hvitfeldtska Foundation, Gothenburg, Sweden and the Swedish Dental Association. We also would like to express sincere gratitude to Ms. Helena Johansson for her excellent and valuable guidance regarding the statistics in the paper.

Disclosure statement

No potential conflict of interest was reported by the authors.