RISK FACTORS FOR JAW OSTEORADIONECROSIS: A CASE CONTROL STUDY

Abstract

Objectives To identify factors that predispose to development of osteoradionecrosis (ORN) of the jaw. Study Design A retrospective hospital-based case-control study was conducted with patients with head and neck cancer submitted to ≥60 Gy external radiotherapy with incidence over the jaws. A total of 19 cases of ORN and 43 controls were included. Patients’ demographic data, tumor type, staging, treatment and outcome information, and pretreatment oral status were collected. Results Univariate analysis showed that oral cavity/oropharynx was associated with a 9.77-fold increased risk of ORN development compared to other sites (P = .005). Being an active smoker was associated with a 3.95-fold increased risk of ORN development (P = .01). A tendency toward an increased risk for ORN was observed particularly when the extraction occurred after radiotherapy (odds ratio [OR] = 3.04; P = .08). On multivariate analysis, tumor site was the only significant risk factor in this analysis, with an OR of 21.03 (P = .01). Conclusions Oral and oropharyngeal primary site should be considered as an important risk factor for ORN. However, being an active smoker and being submitted to dental extraction after radiotherapy should be taken in account during the management of these patients. To identify factors that predispose to development of osteoradionecrosis (ORN) of the jaw. A retrospective hospital-based case-control study was conducted with patients with head and neck cancer submitted to ≥60 Gy external radiotherapy with incidence over the jaws. A total of 19 cases of ORN and 43 controls were included. Patients’ demographic data, tumor type, staging, treatment and outcome information, and pretreatment oral status were collected. Univariate analysis showed that oral cavity/oropharynx was associated with a 9.77-fold increased risk of ORN development compared to other sites (P = .005). Being an active smoker was associated with a 3.95-fold increased risk of ORN development (P = .01). A tendency toward an increased risk for ORN was observed particularly when the extraction occurred after radiotherapy (odds ratio [OR] = 3.04; P = .08). On multivariate analysis, tumor site was the only significant risk factor in this analysis, with an OR of 21.03 (P = .01). Oral and oropharyngeal primary site should be considered as an important risk factor for ORN. However, being an active smoker and being submitted to dental extraction after radiotherapy should be taken in account during the management of these patients.