preprint · F1000Research
Osteoradionecrosis is a severe complication resulting from radiotherapy for head and neck cancers. This retrospective study examined 46 patients treated with hyperbaric oxygen therapy between 2017 and 2020 to determine the therapy's role and identify factors predicting disease progression. Most cases affected the mandible. Following treatment, which averaged around 45 sessions per patient, the condition regressed in 33 percent of cases and stabilised in 45 percent, while 22 percent experienced worsening lesions. Univariate analysis linked progression to factors including high blood pressure, larger tumour sizes, advanced cancer stages, radiation dose, the timing between dental care and radiotherapy, mandibular lesion location, and session count. Multivariate analysis confirmed that a higher number of hyperbaric sessions and the interval between dental interventions and radiotherapy significantly influence post-therapeutic patient outcomes.
Radiotherapy for head and neck cancers can lead to painful, debilitating bone damage known as osteoradionecrosis. Identifying which patient characteristics and treatment protocols predict recovery helps healthcare teams refine post-radiation therapies, allocate specialist hyperbaric oxygen resources more effectively, and improve preventative dental timelines for cancer patients.
This clinical research provides insights relevant to hospital departments, oncology units, and operators of hyperbaric oxygen facilities. The identified predictive factors could inform clinical guidelines and treatment protocols for dosing therapy sessions. Because this is a retrospective clinical evaluation, the findings require validation in prospective trials before formal inclusion in standardised clinical pathways or commercial decision-support tools.
AI-generated from the published abstract. Always read the original work before citing.
<ns4:p>Introduction Although relatively uncommon, osteoradionecrosis (ORN) remains a serious complication following radiotherapy. Various therapeutic approaches, including hyperbaric oxygen therapy (HBOT), are utilized in managing ORN. This study aims to evaluate the role of HBOT in ORN management and to identify predictive factors influencing the evolution of head and neck ORN after HBOT. Methods This retrospective study includes 46 patients who received HBOT for head and neck ORN between 2017 and 2020. The patients were divided into two groups: Group 1 (n=36) included those with regression or stabilization of ORN, while Group 2 (n=10) comprised patients with worsening lesions. We performed a statistical study in order to identify factors influencing ORN progression under treatment. Results ORN affected the mandible in 93.5% of patients, the maxilla in 2 cases, and the skull base in 4 cases. All patients received HBOT, with an average of 44.65 sessions. Pre-operative HBOT was administered in 17% of cases, and post-operative HBOT was given in 42% of cases. After at least 20 sessions, ORN regressed in 33% of cases, stabilized in 45%, and worsened in 22%. Analysis of factors influencing ORN progression on the univariate study revealed significant associations with high blood pressure (p=0.046), larger tumor size (p=0.004), advanced tumor stages (p=0.048), mean radiation dose (p=0.002), delays between dental care and radiotherapy (p=0.045), and the location of ORN within the mandible (p=0.049). Additionally, the number of HBOT sessions significantly affected ORN evolution, with more sessions correlating with better outcomes (p=0.001). In the multivariate analysis, variables such as the average interval between dental care and radiotherapy (p=0.043) as well as the number of HBOT sessions (p=0.040) emerged as significant influencers of ORN evolution. Conclusion Our study provides valuable insights into the management of ORN by identifying key predictors that influence the post-therapeutic evolution of head and neck ORN after HBOT.</ns4:p>
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.12688/f1000research.155112.2
Is something wrong with this record? Report it or request removal.
Discussion
Have you built on this work, tried to replicate it, or seen it applied in practice? Share what you know. Verified researchers and MARATTO™ domain experts can open a discussion, and any member can reply. Contributions are reviewed before they appear.
No discussion yet. Open the first thread.
New to MARATTO™? Create a free account.
