title: Effectiveness of intensity-modulated and image-guided radiotherapy to spare the mandible from excessive radiation.
abstract: We would like to assess the effectiveness of intensity-modulated radiotherapy (IMRT) or image-guided radiotherapy (IGRT) to decrease the risk of osteoradionecrosis in locally advanced head and neck cancer. We conducted a retrospective study of 83 patients with head and neck cancer undergoing concurrent definitive chemoradiation, post-operative radiotherapy or chemoradiation, or radiotherapy alone with IMRT or IGRT. Mean mandibular dose was, respectively, 43.6Gy and 43.8Gy for the IMRT and IGRT technique. At a median follow-up of 28 months (5-55 months), only one patient developed osteoradionecrosis requiring hyperbaric oxygen. Sharp dose falloff associated with IMRT and IGRT decreased excessive radiation of the mandible and may reduce the risks of osteoradionecrosis.
authors.affiliation: Department of Radiation Oncology, University of Arizona, Tucson, AZ, United States. NamPhong.Nguyen@yahoo.com
authors.forename: Nam P
authors.initials: NP
authors.lastname: Nguyen
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Vock
authors.forename: Alexander
authors.initials: A
authors.lastname: Chi
authors.forename: Lars
authors.initials: L
authors.lastname: Ewell
authors.forename: Paul
authors.initials: P
authors.lastname: Vos
authors.forename: Melissa
authors.initials: M
authors.lastname: Mills
authors.forename: Rihan
authors.initials: R
authors.lastname: Khan
authors.forename: Fabio
authors.initials: F
authors.lastname: Almeida
authors.forename: Rick
authors.initials: R
authors.lastname: Davis
authors.forename: Michael
authors.initials: M
authors.lastname: Betz
authors.forename: Siyoung
authors.initials: S
authors.lastname: Jang
authors.forename: Steve
authors.initials: S
authors.lastname: Gelumbauskas
authors.forename: Richard P
authors.initials: RP
authors.lastname: Vo
authors.forename: Vincent
authors.initials: V
authors.lastname: Vinh-Hung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008334:Mandible / Q000528:radiation effects*; D008336:Mandibular Diseases / Q000517:prevention & control*; D008875:Middle Aged; D010025:Osteoradionecrosis / Q000517:prevention & control*; D011879:Radiotherapy Dosage; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D012189:Retrospective Studies