title: The efficacy of hyperbaric oxygen therapy related to the clinical stage of osteoradionecrosis of the mandible.
abstract: This study aimed to evaluate the success of hyperbaric oxygen therapy (HBOT) and surgery in the treatment of mandibular osteoradionecrosis (ORN) in relation to the extent of the ORN. Twenty-seven patients with ORN were identified from a total of 509 patients with a history of primary oral or base of the tongue cancer; these patients had been treated with radiation therapy with curative intent between 1992 and 2006, with a radiation dose to the mandible of ≥50Gy. The ORN was staged according to the classification of Notani et al. The time from completion of radiation therapy to the development of ORN varied (median 3 years). Forty HBOT sessions were offered. After HBOT alone, 3 of 11 stage I lesions, 0 of 8 stage II lesions, and 0 of 8 stage III lesions had healed (P=0.0018). An absolute incidence of 5.3% ORN was found in this population. Of all sites irradiated in this study, the floor of the mouth was most associated with ORN (8.6%), whereas the cheek was least associated (0%). Based on the results of this study, HBOT can be recommended for stage I and II ORN and for selected cases of stage III ORN.
authors.affiliation: Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Centre, University Medical Center Utrecht, The Netherlands; Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre Nijmegen, The Netherlands.
authors.forename: F J
authors.initials: FJ
authors.lastname: Dieleman
authors.affiliation: Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre Nijmegen, The Netherlands.
authors.forename: T T T
authors.initials: TTT
authors.lastname: Phan
authors.affiliation: Department of Otorhinolaryngology and Head and Neck surgery, Radboud University Medical Centre Nijmegen, The Netherlands.
authors.forename: F J A
authors.initials: FJA
authors.lastname: van den Hoogen
authors.affiliation: Department of Radiation Oncology, Radboud University Medical Centre Nijmegen, The Netherlands.
authors.forename: J H A M
authors.initials: JHAM
authors.lastname: Kaanders
authors.affiliation: Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre Nijmegen, The Netherlands. Electronic address: thijs.merkx@radboudumc.nl.
authors.forename: M A W
authors.initials: MAW
authors.lastname: Merkx
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008336:Mandibular Diseases / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D010025:Osteoradionecrosis / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D011879:Radiotherapy Dosage; D014062:Tongue Neoplasms / Q000532:radiotherapy*; D016896:Treatment Outcome
keywords: hyperbaric oxygen therapy; mandible; osteoradionecrosis; radiation therapy