Journal article
Osteoradionecrosis of the mandibula in patients treated with different fractionations.
- Studer G Department of Radiation Oncology, University Hospital Zurich, Switzerland. Gabriela.Studer@usz.ch
- Grätz KW
- Glanzmann C
- 2004-04-02
Published in:
- Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]. - 2004
Chi-Square Distribution
Dental Care
Dose Fractionation, Radiation
Follow-Up Studies
Head and Neck Neoplasms
Humans
Incidence
Mandible
Mandibular Diseases
Osteoradionecrosis
Proportional Hazards Models
Radiotherapy
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Time Factors
Tomography, X-Ray Computed
English
PURPOSE
The incidence of osteonecrosis of the mandibula (ON) after irradiation using modern three-dimensional planning as well as hyperfractionation or moderately accelerated irradiation has been evaluated and compared with the incidence of the preceding period.
PATIENTS AND METHODS
The records of 268 head and neck cancer patients irradiated between January 1, 1980 and December 31, 1998 with a dose to the mandibula of at least 60 Gy were retrospectively analyzed. All patients had CT-based treatment planning, computerized dose calculation with isodose charts also in several off-axis planes, and regular verification films.
RESULTS
The long-term cumulative incidence of ON needing mandibular resection was as follows: after conventional fractionation 6.2% (between 60 and 66.6 Gy target dose) or 20.1% (between > 66.6 and 72 Gy); after hyperfractionated irradiation with a target dose between 72 and 78.8 Gy 6.6%; after concomitant boost irradiation according to the MDA/Houston regime with a dose between 63.9 and 70.5 Gy: no case; after 6 x 2 Gy/week or 7 x 1.8 Gy/week and a total target dose between 66 and 72 Gy approximately 17% or higher (small patient number).
CONCLUSION
Comparison of the incidence of ON during the period between 1980 and 1990 with the following period between 1990 and 1998 shows a decrease in risk to a value of approximately 5% using modern three-dimensional techniques as well as hyperfractionation or moderately accelerated fractionation.
The incidence of osteonecrosis of the mandibula (ON) after irradiation using modern three-dimensional planning as well as hyperfractionation or moderately accelerated irradiation has been evaluated and compared with the incidence of the preceding period.
PATIENTS AND METHODS
The records of 268 head and neck cancer patients irradiated between January 1, 1980 and December 31, 1998 with a dose to the mandibula of at least 60 Gy were retrospectively analyzed. All patients had CT-based treatment planning, computerized dose calculation with isodose charts also in several off-axis planes, and regular verification films.
RESULTS
The long-term cumulative incidence of ON needing mandibular resection was as follows: after conventional fractionation 6.2% (between 60 and 66.6 Gy target dose) or 20.1% (between > 66.6 and 72 Gy); after hyperfractionated irradiation with a target dose between 72 and 78.8 Gy 6.6%; after concomitant boost irradiation according to the MDA/Houston regime with a dose between 63.9 and 70.5 Gy: no case; after 6 x 2 Gy/week or 7 x 1.8 Gy/week and a total target dose between 66 and 72 Gy approximately 17% or higher (small patient number).
CONCLUSION
Comparison of the incidence of ON during the period between 1980 and 1990 with the following period between 1990 and 1998 shows a decrease in risk to a value of approximately 5% using modern three-dimensional techniques as well as hyperfractionation or moderately accelerated fractionation.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1007/s00066-004-1171-z
- PMID 15057434
- Persistent URL
- https://sonar.ch/global/documents/104022
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