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Igor Henrique Morais Silva - One of the best experts on this subject based on the ideXlab platform.
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Pentoxifylline, tocopherol, and sequestrectomy are effective for the management of advanced Osteoradionecrosis of the jaws—a case series
Supportive Care in Cancer, 2020Co-Authors: Raíssa Soares Anjos, Giovana Nóbrega Pádua Walfrido, Rômulo Oliveira Hollanda Valente, Luiz Alcino Gueiros, Alessandra Albuquerque Tavares Carvalho, Preeyan Patel, Stephen Porter, Jair Carneiro Leão, Igor Henrique Morais SilvaAbstract:Background The aim of the present study was to evaluate the efficacy of pentoxifylline and tocopherol for the management of Osteoradionecrosis of the jaws. Methods Twenty-five patients diagnosed with Osteoradionecrosis of the jaws treated with pentoxifylline 400 mg + tocopherol 400 mg three times daily ( tid ) were evaluated. Clinical records and image tests were reviewed. All patients were previously submitted to head and neck radiation therapy and presented with a clinical and radiographic diagnosis of Osteoradionecrosis of the jaws. Results Following therapy with pentoxifylline and tocopherol, 76% (19/25) of the patients showed complete mucosal healing, in which 47.3% (9/19) did not undergo sequestrectomy. From this particular group, 77.7% (7/9) were in stage I and 33.3% (3/9) used the protocol for up to 3 months. Among those who underwent to sequestrectomy, complete mucosal healing was observed in 52.7% (10/19). Among these, 60% (6/10) were in stage I and 100% of the patients were using the protocol for more than 3 months. In all other patients, partial healing of the mucosa was observed since they presented advanced disease. These represented 24% of the sample (6/25), 66.6% (4/6) were in stage III, and 60% (4/6) used the protocol for over 6 months. Conclusion Pentoxifylline and tocopherol may provide effective management of Osteoradionecrosis of the jaws, and the association with sequestrectomy may avoid major surgical procedures.
Raíssa Soares Anjos - One of the best experts on this subject based on the ideXlab platform.
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Pentoxifylline, tocopherol, and sequestrectomy are effective for the management of advanced Osteoradionecrosis of the jaws—a case series
Supportive Care in Cancer, 2020Co-Authors: Raíssa Soares Anjos, Giovana Nóbrega Pádua Walfrido, Rômulo Oliveira Hollanda Valente, Luiz Alcino Gueiros, Alessandra Albuquerque Tavares Carvalho, Preeyan Patel, Stephen Porter, Jair Carneiro Leão, Igor Henrique Morais SilvaAbstract:Background The aim of the present study was to evaluate the efficacy of pentoxifylline and tocopherol for the management of Osteoradionecrosis of the jaws. Methods Twenty-five patients diagnosed with Osteoradionecrosis of the jaws treated with pentoxifylline 400 mg + tocopherol 400 mg three times daily ( tid ) were evaluated. Clinical records and image tests were reviewed. All patients were previously submitted to head and neck radiation therapy and presented with a clinical and radiographic diagnosis of Osteoradionecrosis of the jaws. Results Following therapy with pentoxifylline and tocopherol, 76% (19/25) of the patients showed complete mucosal healing, in which 47.3% (9/19) did not undergo sequestrectomy. From this particular group, 77.7% (7/9) were in stage I and 33.3% (3/9) used the protocol for up to 3 months. Among those who underwent to sequestrectomy, complete mucosal healing was observed in 52.7% (10/19). Among these, 60% (6/10) were in stage I and 100% of the patients were using the protocol for more than 3 months. In all other patients, partial healing of the mucosa was observed since they presented advanced disease. These represented 24% of the sample (6/25), 66.6% (4/6) were in stage III, and 60% (4/6) used the protocol for over 6 months. Conclusion Pentoxifylline and tocopherol may provide effective management of Osteoradionecrosis of the jaws, and the association with sequestrectomy may avoid major surgical procedures.
Sylvie Chevret - One of the best experts on this subject based on the ideXlab platform.
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hyperbaric oxygen therapy for radionecrosis of the jaw a randomized placebo controlled double blind trial from the orn96 study group
Journal of Clinical Oncology, 2004Co-Authors: Djillali Annane, J Depondt, Philippe Aubert, Maryvonne Villart, P Gehanno, Philippe Gajdos, Sylvie ChevretAbstract:Purpose To determine the efficacy and safety of hyperbaric oxygen therapy (HBO) for overt mandibular Osteoradionecrosis. Patients and Methods This prospective, multicenter, randomized, double-blind, placebo-controlled trial was conducted at 12 university hospitals. Ambulatory adults with overt Osteoradionecrosis of the mandible were assigned to receive 30 HBO exposures preoperatively at 2.4 absolute atmosphere for 90 minutes or a placebo, and 10 additional HBO dives postoperatively or a placebo. The main outcome measure was 1-year recovery rate from Osteoradionecrosis. Secondary end points included time to treatment failure, time to pain relief, 1-year mortality rate, and treatment safety. Results At the time of the second interim analysis, based on the triangular test, the study was stopped for potentially worse outcomes in the HBO arm. A total of 68 patients were enrolled and analyzed. At 1 year, six (19%) of 31 patients had recovered in the HBO arm and 12 (32%) of 37 in the placebo arm (relative risk =...
Dehui Wang - One of the best experts on this subject based on the ideXlab platform.
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endoscopic sequestrectomy for skull base Osteoradionecrosis in nasopharyngeal carcinoma patients a 10 year experience
International Journal of Clinical Oncology, 2019Co-Authors: Juan Liu, Xianhui Ning, Xicai Sun, Dehui WangAbstract:Background Skull base Osteoradionecrosis is a devastating post-irradiation complication in nasopharyngeal carcinoma patients. We conducted a retrospective analysis to assess the long-term survival and prognostic factors of patients with skull base Osteoradionecrosis treated with endoscopic sequestrectomy. Methods We enrolled 59 nasopharyngeal carcinoma patients with skull base Osteoradionecrosis who underwent endoscopic nasopharyngectomy. The clinical characteristics and outcome at the last follow-up visit were collected. The survival curve and univariate and multivariate survival analysis were analyzed by Kaplan-Meier and Cox proportional hazards model to analyze the potential prognostic factors of overall survival, including age, gender, number of radiation, number of operations, extension of disease (local or extensive), whether the ICA is exposed to the procedure (yes or no) and the hypha status (yes or no) at postoperative pathological examination. Results The predilection sites of skull base Osteoradionecrosis in Osteoradionecrosis patients are as follows: the base of the sphenoid bone and sphenoid sinus region, the clivus and petrous apex region including the internal carotid canal and the pterygoid process region (including its medial and lateral pterygoid plates). After surgery, clinical symptoms were alleviated in most patients to varying degrees. By the last follow-up visit, 26 patients had died. Most deaths (24) in the study occurred during the first 2 years. Most patients (24) died of sudden severe hemorrhage. The follow-up period ranged from 1 to 108 months, with a median of 27 months. The 2-year overall survival rate was 54.2%. Multivariate Cox regression analysis showed that the number of radiation (P = 0.026) and age (P = 0.002) were independent risk factors for the overall survival. Conclusions Endoscopic sequestrectomy with minimal complications and clear vision is a valuable option for the therapy of skull base Osteoradionecrosis in nasopharyngeal carcinoma patients.
Klaus-dietrich Wolff - One of the best experts on this subject based on the ideXlab platform.
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Surgical outcome and prognostic factors after treatment of Osteoradionecrosis of the jaws
Journal of Cancer Research and Clinical Oncology, 2013Co-Authors: Thomas Mücke, Janett Koschinski, Denys J. Loeffelbein, Herbert Deppe, David A. Mitchell, Anastasios Kanatas, Klaus-dietrich WolffAbstract:Purpose This prospective study attempts to identify prognostic factors for outcome in patients Classes 2 and 3 Osteoradionecrosis (ORN) treated using individualized methods. Methods From 2005 to 2010, patients with Classes 2 and 3 Osteoradionecrosis of the jaws were treated by the same surgical team using standard protocols. The patients were evaluated prospectively and followed up for a minimum of 12 months after completion of treatment. Two examinations were performed at least six months apart. Results A total of 94 patients were assessed. Local debridement was performed in 33 patients (35.1 %), a rim resection with the application of a reconstruction plate was performed in 35 patients (37.2 %), and continuity resection in 26 patients (27.7 %). Postoperative wound infections locally or at the neck were detected in 69 patients (70.2 %), failure to eradicate radionecrosis occurred in 50 patients (53.2 %). The location of the primary tumor ( p = 0.023) and radiation dose ( p = 0.049), were associated with a significant risk of development of ORN. Prognostic factors for failure of treatment were the extent of initial Osteoradionecrosis ( p = 0.049) surgical treatment ( p
