Sathasivam Hans P, Davies Gareth R, Boyd Nicholas M
University of Western Australia, 35 Stirling Highway Crawley WA 6009, Perth, Australia.
Dental Department, Sultan Ismail Hospital, 81100 Johor Bahru, Malaysia.
Head Neck. 2018 Jan;40(1):46-54. doi: 10.1002/hed.24907. Epub 2017 Nov 17.
Osteoradionecrosis of the jaw (ORNJ) is a well-recognized complication of radiotherapy. The purpose of this study was to assess predictive factors for the development of ORNJ.
A retrospective study of 325 patients with head and neck squamous cell carcinoma (HNSCC) treated at one institution between January 1, 1999, and December 31, 2008, was conducted. Outcome measure was the presence/absence of ORNJ. Time to event was recorded and Cox proportional hazard regression analysis was used to determine statistically significant predictive factors.
Fifty-nine patients had ORNJ. Statistical analysis using Cox regression analysis identified several statistically significant variables: dentoalveolar surgery; peri-resective surgery of the jaw; continued tobacco usage after radiotherapy, diabetes mellitus type 2 (DM2); and total radiation dose.
Patients at greater risk of developing ORNJ can be identified and measures can be instituted to reduce its incidence and expedite management when it does occur.
颌骨放射性骨坏死（ORNJ）是一种公认的放射治疗并发症。本研究的目的是评估ORNJ发生的预测因素。
对1999年1月1日至2008年12月31日在某机构接受治疗的325例头颈部鳞状细胞癌（HNSCC）患者进行回顾性研究。观察指标为ORNJ的有无。记录事件发生时间，并采用Cox比例风险回归分析确定具有统计学意义的预测因素。
59例患者发生ORNJ。使用Cox回归分析的统计分析确定了几个具有统计学意义的变量：牙槽外科手术；颌骨切除周围手术；放疗后继续吸烟、2型糖尿病（DM2）；以及总辐射剂量。
可以识别出发生ORNJ风险较高的患者，并采取措施降低其发生率，在ORNJ发生时加快治疗。
