Osteoradionecrosis rates after head and neck radiation therapy: Beyond the numbers Review


Authors: Yang, F.; Wong, R. J.; Zakeri, K.; Singh, A.; Estilo, C. L.; Lee, N. Y.
Review Title: Osteoradionecrosis rates after head and neck radiation therapy: Beyond the numbers
Abstract: Purpose: Osteoradionecrosis (ORN) is a severe late complication of head and neck radiation therapy shown to have profound negative effect on the quality of life of cancer survivors. Over the past few decades, improvements in radiation delivery techniques have resulted in a decrease in the incidence of ORN. However, even with modern radiation therapy techniques, ORN remains an important clinical concern. In recent literature, there is a wide range of reported ORN rates from 0% to as high as 20%. With such a high level of variability in the reported incidence of ORN, oncologists often encounter difficulties estimating the risk of this serious radiation therapy toxicity. Methods and Materials: In this review, the authors present a summary of the factors that contribute to the high level of variability in the reported incidence of ORN. Results: Variable definition, variable grading, and heterogeneity of both study inclusion criteria and treatment parameters can each significantly influence the reporting of ORN rates. Conclusions: Given numerous factors can affect the reported incidence of ORN, a thorough understanding of the clinical context behind the reported ORN rates is needed to comprehend the true risk of this important radiation therapy toxicity. © 2024 American Society for Radiation Oncology
Keywords: cancer chemotherapy; review; head and neck surgery; disease classification; cancer radiotherapy; radiation dose; incidence; risk; head and neck cancer; radiation dose fractionation; therapy effect; osteoradionecrosis; proton therapy; diagnostic criteria; re-irradiation; human; grading scheme; head and neck radiotherapy
Journal Title: Practical Radiation Oncology
Volume: 14
Issue: 4
ISSN: 1879-8519
Publisher: Elsevier Inc.  
Date Published: 2024-07-01
Start Page: e264
End Page: e275
Language: English
DOI: 10.1016/j.prro.2024.02.008
PUBMED: 38649030
PROVIDER: scopus
DOI/URL:
Notes: Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Cherry Estilo
    96 Estilo
  2. Nancy Y. Lee
    884 Lee
  3. Richard J Wong
    419 Wong
  4. Kaveh Zakeri
    83 Zakeri
  5. Annu Singh
    25 Singh
  6. Fan Yang
    5 Yang