What question did this study set out to answer?

This study aims to identify risk factors affecting wound healing in osteoradionecrosis patients after radiotherapy.

April 25, 2026American Journal of Otolaryngology0 citationsOpen Access

Prognostic risk factors in patients with jaw osteoradionecrosis: A retrospective cohort study at a tertiary teaching hospital

CLChen-xi LiPeople's Hospital of Xinjiang Uygur Autonomous Region ZGZhong-cheng GongPeople's Hospital of Xinjiang Uygur Autonomous Region SJSakendeke JumataiXinjiang Medical University

Key Points

This study aims to identify risk factors affecting wound healing in osteoradionecrosis patients after radiotherapy.
Retrospective cohort study including 106 patients treated from 2005 to 2020.
Patients classified into normal wound healing and delayed wound healing groups.
Univariate analysis and multivariate logistic regression used to pinpoint independent risk factors.
Diabetes mellitus (OR = 9.687, p = 0.010) and Charlson comorbidity index (CCI, OR = 10.004, p < 0.001) significantly increase risk for delayed healing.
PIV and SII are independent predictors for healing outcomes with significant p-values (< 0.001).
Patients in the highest PIV tertile had a 1.7-fold longer median time-to-healing (31.5 vs 18.3 days, Log-rank p < 0.001).

Abstract

Osteoradionecrosis of the jaws (ORNJ) is a severe complication of radiotherapy for head and neck cancer, with limited data on prognostic factors. This study aimed to identify risk factors associated with wound healing prognosis in ORNJ patients. A retrospective cohort study was conducted following STROBE guidelines, including 106 ORNJ patients treated at a tertiary hospital between 2005 and 2020. Patients were divided into normal wound healing (NH, within 7–10 days postoperatively) and delayed wound healing (DH, ≥11 days postoperatively) groups. Univariate analysis, multivariate Logistic regression, and Cox proportional hazards models were used to identify prognostic factors. The median follow-up was 38.6 months. Univariate analysis showed DH patients had significantly higher baseline PIV (median: 490.1 vs 437.8) and SII (median: 775.6 vs 732.2) than NH patients (all p < 0.001). Multivariate logistic regression showed that diabetes mellitus (OR = 9.687, p = 0.010), Charlson comorbidity index (CCI, OR = 10.004, p < 0.001), primary tumor site (OR = 10.384, p = 0.006), T stage (OR = 27.340, p < 0.001), ORNJ grade at diagnosis (OR = 4.367, p < 0.001), pan-immune-inflammatory value (PIV, OR = 1.043, p < 0.001), and systemic immune-inflammatory index (SII, OR = 1.023, p < 0.001) were independent risk factors for delayed healing. Kaplan-Meier curves showed that patients in the highest PIV tertile had significantly longer time-to-healing (median: 31.5 vs 18.3 days, Log-rank p < 0.001). PIV and SII, along with clinical factors (diabetes mellitus, CCI, T stage, ORNJ grade), are independent prognostic factors for wound healing in ORNJ patients. These findings may help clinicians optimize treatment strategies and predict outcomes. • First study to identify PIV and SII as independent prognostic factors for wound healing in ORNJ patients. • Diabetes mellitus, CCI, T stage and ORNJ grade are clinical predictors of delayed ORNJ wound healing. • Highest PIV tertile correlates with 1.7-fold longer median time-to-healing in ORNJ patients. • V58 radiation dose-volume metric is an independent predictor in ORNJ patients.

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