A case series that included 122 patients found that the prevalence of osteoradionecrosis (ORN) following proton radiation therapy (PRT) was 10.6%, indicating that ORN remains a “clinical challenge,” according to results published in JAMA Otolaryngology-Head and Neck Surgery. Cherry L. Estilo, DMD, and colleagues examined the prevalence of ORN of the jaw in patients with head and neck cancer after PRT. Among 122 patients (mean age, 63; 63.1% men), 10.6% developed ORN spontaneously following PRT during a median follow-up of 40.6 months. Most patients (N=9) had grade 2 ORN at diagnosis, and the posterior ipsilateral
mandible within the radiation field that received the full planned PRT dose was the most involved site. At a median follow-up of 13.5 months from ORN diagnosis, complete resolution, stability, and progression of ORN were seen in three, six, and four patients, respectively. The 3-year rates of ORN and death in the total cohort were 5.2% and 21.5%, respectively; the 5-year rates of ORN and death were 11.5% and 34.4%, respectively.
