Risk factors for osteoradionecrosis of the jaw in patients with head and neck squamous cell carcinoma.
Risk factors for osteoradionecrosis of the jaw in patients with head and neck squamous cell carcinoma.
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DOI：
10.1186/s13014-020-01701-5
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发表时间：
2021-01-05
期刊：
影响因子：
--
通讯作者：
Sasaki R
中科院分区：
文献类型：
--
作者：
Kubota H;Miyawaki D;Mukumoto N;Ishihara T;Matsumura M;Hasegawa T;Akashi M;Kiyota N;Shinomiya H;Teshima M;Nibu KI;Sasaki R
目的评价头颈部鳞状细胞癌(HNSCC)患者颌骨放射性骨坏死(ORNJ)的相关因素，重点研究颌骨相关剂量-体积直方图(DVH)参数。我们回顾了2008-2018年间接受治疗性意向或术后放射治疗的616例HNSCC患者的病历。调查患者相关(年龄、性别、吸烟或酗酒史、糖尿病、功能状态、放疗前牙科评估、放疗前或放疗后拔牙)、肿瘤相关(原发肿瘤部位、T分期、淋巴结状态)和治疗相关(放疗前手术、放疗前下颌骨手术、诱导或同时化疗、放疗技术)变量和DVH参数(颌骨相对体积暴露于10Gy70Gy[V10-70])，并比较有无ORNJ患者之间的差异。放射剂量参数比较采用Mann-Whitney U检验。使用单变量和多变量Cox回归分析来评估与ORNJ发生相关的因素。采用Kaplan-Meier分析进行累积ORNJ发病率估计。46例患者(7.5%)发展为ORNJ。中位随访期为40(3-145)个月。发生ORNJ的中位时间为27(2-127)个月。DVH分析显示，ORNJ患者的V30-V70值显著高于无ORNJ患者。在单因素分析中，原发肿瘤部位、放疗前下颌骨手术、放疗后拔牙和V60 >； 14%被确定为重要因素。在多变量分析中，V60 >； 占14%(p = 0.0065)和原发肿瘤部位(p = 0.0059)仍然显著。V60 ≤ 患者和 >； 患者3年累积口腔癌发病率分别为2.5%和8.6%(p <； 0.0001)，口咽癌、口腔癌和其他癌症患者分别为9.3%和1.4%(p <； 0.0001)。V60、 >； 、14%和口咽癌、口腔癌是口腔颌面部坏死的独立危险因素。这些发现可能有助于减少接受根治性放疗的HNSCC的ORNJ发生率。
To evaluate factors associated with osteoradionecrosis of the jaw (ORNJ) in patients with head and neck squamous cell carcinoma (HNSCC), focusing on jaw-related dose–volume histogram (DVH) parameters. We retrospectively reviewed the medical records of 616 patients with HNSCC treated with curative-intent or postoperative radiation therapy (RT) during 2008–2018. Patient-related (age, sex, history of smoking or alcohol use, diabetes mellitus, performance status, pre-RT dental evaluation, pre- or post-RT tooth extraction), tumor-related (primary tumor site, T-stage, nodal status), and treatment-related (pre-RT surgery, pre-RT mandible surgery, induction or concurrent chemotherapy, RT technique) variables and DVH parameters (relative volumes of the jaw exposed to doses of 10 Gy–70 Gy [V10–70]) were investigated and compared between patients with and without ORNJ. The Mann–Whitney U test was used to compare RT dose parameters. Univariate and multivariate Cox regression analyses were used to assess factors associated with ORNJ development. Kaplan–Meier analyses were performed for cumulative ORNJ incidence estimation. Forty-six patients (7.5%) developed ORNJ. The median follow-up duration was 40 (range 3–145) months. The median time to ORNJ development was 27 (range 2–127) months. DVH analysis revealed that V30–V70 values were significantly higher in patients with than in those without ORNJ. In univariate analyses, primary tumor site, pre-RT mandible surgery, post-RT tooth extraction, and V60 > 14% were identified as important factors. In multivariate analyses, V60 > 14% (p = 0.0065) and primary tumor site (p = 0.0059) remained significant. The 3-year cumulative ORNJ incidence rates were 2.5% and 8.6% in patients with V60 ≤ 14% and > 14%, respectively (p < 0.0001), and 9.3% and 1.4% in patients with oropharyngeal or oral cancer and other cancers, respectively (p < 0.0001). V60 > 14% and oropharyngeal or oral cancer were found to be independent risk factors for ORNJ. These findings might be useful to minimize ORNJ incidence in HNSCC treated with curative RT.
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对医疗统计信息的自由使用的易于使用的软件“ EZR”的调查。
影响因子：
4.8
作者：
Kanda Y
通讯作者：
Kanda Y
DOI：
10.1002/hed.20538
发表时间：
2007-06-01
影响因子：
2.9
作者：
Chang, Daniel T.;Sandow, Pamela R.;Mendenhall, William M.
通讯作者：
Mendenhall, William M.
DOI：
10.1002/hed.23949
发表时间：
2016-05-01
影响因子：
2.9
作者：
Chen, Jyun-An;Wang, Chen-Chi;Liu, Shih-An
通讯作者：
Liu, Shih-An
影响因子：
1.9
作者：
Goldwaser, Batya R.;Cbuang, Sung-Kiang;August, Mereditb
通讯作者：
August, Mereditb
DOI：
10.1186/s13014-016-0679-6
发表时间：
2016-07-30
期刊：
Radiation oncology (London, England)
影响因子：
--
作者：
Kuhnt T;Stang A;Wienke A;Vordermark D;Schweyen R;Hey J
通讯作者：
Hey J