Analysis of risk factors for mandibular bone radionecrosis after exclusive low dose-rate brachytherapy for oral cancer

Impact of Superselective Intra-Arterial and Systemic Chemoradiotherapy for Gingival Carcinoma; Analysis of Treatment Outcomes and Prognostic Factors

“…However, the overall outcome of the present study was comparable, or favorable, to previous reports of surgery and postoperative RT. Other reports on IACRT-treated oral cancers reported distant metastasis rates to be 10-23% [10,11], whereas in the present study, it was lower in the IACRT group (12.1%) than in the SCRT group (22.2%), and half of patients who developed distant metastasis did not have controlled primary tumors. Furthermore, three of four (75%) IACRT patients were pathologically con rmed to have no evidence of malignancy in their neck lymph nodes after lymph node dissection.…”

“…For unresectable cases, various chemoradiation therapies (CRT) are used, and may include super-selective intra-atrial, intravenous, or oral chemotherapy delivery. Intra-arterial chemoradiation (IACRT) is effective for primary tumors, but might be inappropriate for distant metastases [10,11].…”

Curative Brachytherapy for Recurrent/Residual Tongue Cancer

“…Wang et al observed no severe local complications after external reirradiation with ≥ 130 Gy for recurrent laryngeal carcinoma by using the reduced radiation portal limited to the recurrent lesion [31]. The incidence of late postbrachytherapy complications is closely related to the dose of external irradiation, the brachytherapy source used, dose rate, total dose, and use of a spacer [5,13,16]. The severest late complication of our curative brachytherapy for recurrent/residual cancer was bone exposure, and it healed without requiring surgery.…”

Mandibular osteoradionecrosis: reconstructive surgery

“…The increased complication rate seen in our study may be due to the patients receiving higher radiation doses, on average 75 Gy, with half of the patients receiving combined external and brachytherapy in the range of 80 Gy. The cumulative detrimental effects of external beam radiotherapy and brachytherapy on tissue viability and radionecrosis development have been reported 1,11 , 12 …”

“…The cumulative detrimental effects of external beam radiotherapy and brachytherapy on tissue viability and radionecrosis development have been reported. 1,11,12 Radionecrotic tissues are characterized as hypoxic, hypocellular and hypovascular, with lack of fibroblast growth and collagen formation, resulting in tissue breakdown and nonhealing wounds. 13 Hyperbaric oxygen therapy as an adjunct is today considered essential in all reconstructions of radionecrotic tissues.…”