Osteoradionecrosis - an old problem with new consequences.

IF 1.9 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Current Opinion in Supportive and Palliative Care Pub Date : 2024-03-01 Epub Date: 2024-12-22 DOI:10.1097/SPC.0000000000000690

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Abstract

Purpose of review: Osteoradionecrosis (ORN) is a devasting complication of radiation therapy (RT), especially in head and neck cancers (HNC), and is still poorly understood. The aim of this review is to report its incidence and consider the risk factors associated with ORN to highlight prevention strategies to decrease its incidence.

Recent findings: The average incidence of ORN is between 2% and 23%, with incidence decreasing in more recent years with the introduction of modern RT technology and better oral health care. Smoking, diabetes mellitus, oropharyngeal and oral cavity cancers, pre- and post-RT dental extractions and a total radiation dose of over 60 Gy were all identified as risk factors for ORN. In prevention, strategies were mainly structured around minimising risk factors or targeting possible mechanisms of ORN's pathophysiology.

Summary: At present, the controversy surrounding the risk factors and pathogenesis of ORN makes it difficult to establish a set of prevention guidelines for its incidence. In order to achieve this, more research examining its aetiology must be conducted as well as a universal staging system within which ORN may be classified.

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骨坏死--老问题，新后果。

综述的目的：骨坏死（ORN）是放射治疗（RT），尤其是头颈部癌症（HNC）的一种严重并发症，但人们对其了解甚少。本综述旨在报告其发病率，并考虑与ORN相关的风险因素，以强调降低其发病率的预防策略：ORN 的平均发病率在 2% 到 23% 之间，近年来随着现代 RT 技术的引入和口腔保健的改善，发病率有所下降。吸烟、糖尿病、口咽癌和口腔癌、RT 前后拔牙以及总辐射剂量超过 60 Gy 都是 ORN 的危险因素。小结：目前，围绕 ORN 的风险因素和发病机制存在争议，因此很难为其发病制定一套预防指南。为此，必须对其病因进行更多的研究，并建立一个通用的分期系统，以便对 ORN 进行分类。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Supportive and Palliative Care HEALTH CARE SCIENCES & SERVICES-

CiteScore

3.70

自引率

0.00%

发文量

期刊介绍： A reader-friendly resource, Current Opinion in Supportive and Palliative Care provides an up-to-date account of the most important advances in the field of supportive and palliative care. Each issue contains either two or three sections delivering a diverse and comprehensive coverage of all the key issues, including end-of-life management, gastrointestinal systems and respiratory problems. Current Opinion in Supportive and Palliative Care is an indispensable journal for the busy clinician, researcher or student.