Predictive modelling of mandibular osteoradionecrosis in head and neck cancer patients: clinical and dosimetric insights

Julian Leeder; Ali Modabber; Frank Hölzle; Michael J. Eble; Ahmed Allam Mohamed

doi:10.1007/s00784-025-06385-3

May 26, 2025Clinical Oral InvestigationsOpen Access

Predictive modelling of mandibular osteoradionecrosis in head and neck cancer patients: clinical and dosimetric insights

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Key Points

Identify clinical and dosimetric risk factors for mandibular osteoradionecrosis (ORN) and create an individualized risk prediction model for patients with head and neck cancer.
Conducted a retrospective case-control study of 298 head and neck cancer patients treated with radiotherapy or chemoradiotherapy between January 2012 and May 2020.
Evaluated mandibular dosimetric parameters (V10–V60, mean dose, maximum dose) alongside clinical variables (age, tumor site, smoking, dental extractions) over a median follow-up of 32.4 months.
Mandibular osteoradionecrosis occurred in 20 patients (6.7%), with a 5-year cumulative incidence of 7.4%.
Multivariate analysis identified post-radiotherapy dental extractions (HR = 2.51, p < 0.0001) and mandibular V50 (HR = 1.05, p = 0.0015; cutoff 25.4 cm³, p = 0.0016) as independent risk factors, while older age was protective (HR = 0.96, p = 0.047).
The multivariate risk prediction model combining age, dental extractions, and mandibular V50 demonstrated high discrimination (C-index = 0.815, AUC = 0.8).

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Implication

Retrospective case-control study demonstrates that radiation dose-volume and tooth removal drive jaw necrosis in head and neck cancer, indicating clear targets for risk prevention.

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Cite This Study

Leeder et al. (2025) studied this question.

synapsesocial.com/papers/6aa936c8aa112b81ac0c0cab https://doi.org/10.1007/s00784-025-06385-3

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Predictive modelling of mandibular osteoradionecrosis in head and neck cancer patients: clinical and dosimetric insights

Key Points

No abstract yet

Implication

Discussion

Cite This Study

Predictive modelling of mandibular osteoradionecrosis in head and neck cancer patients: clinical and dosimetric insights

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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