title: Evaluating the impact of patient, tumor, and treatment characteristics on the development of jaw complications in patients treated for oral cancers: a SEER-Medicare analysis.
abstract: BACKGROUND
  Jaw complications, including osteoradionecrosis, are significant sequelae of radiation therapy (RT) for oral cancers. This study identifies the impact of patient, tumor, and treatment characteristics on the development of jaw complications in patients treated with RT.
  
  
  METHODS
  The Surveillance, Epidemiology, and End Results (SEER)-Medicare database was used to identify patients treated with RT for oral cancers from 1999 to 2007. Jaw complications were identified by International Classification of Diseases 9th revision (ICD-9) diagnosis codes and/or related procedures using Current Procedural Terminology (CPT) and ICD-9 codes.
  
  
  RESULTS
  A total of 1848 patients were identified. With a median follow-up of 2.5 years, 297 patients (16.1%) developed jaw complications: 226 patients had a diagnosis, 41 patients had a procedure, and 30 patients had both. On multivariate analysis, female sex, lack of chemotherapy use, and fewer comorbidities were associated with a statistically significant increase in jaw complications.
  
  
  CONCLUSIONS
  Even with modern techniques, jaw complications are a notable and potentially devastating side effect of RT for oral cancers.
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Beth M
authors.initials: BM
authors.lastname: Beadle
authors.forename: Kai-Ping
authors.initials: KP
authors.lastname: Liao
authors.forename: Mark S
authors.initials: MS
authors.lastname: Chambers
authors.forename: Linda S
authors.initials: LS
authors.lastname: Elting
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Buchholz
authors.forename: K
authors.initials: K
authors.lastname: Kian Ang
authors.forename: Adam S
authors.initials: AS
authors.lastname: Garden
authors.forename: B Ashleigh
authors.initials: BA
authors.lastname: Guadagnolo
mesh_terms: D017677:Age Distribution; D000368:Aged; D016009:Chi-Square Distribution; D015331:Cohort Studies; D016001:Confidence Intervals; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007568:Jaw / Q000528:radiation effects*; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010025:Osteoradionecrosis / Q000175:diagnosis / Q000453:epidemiology*; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D018426:SEER Program; D017678:Sex Distribution; D014481:United States