Article, 2024

Prevention and Management of Osteoradionecrosis in Patients With Head and Neck Cancer Treated With Radiation Therapy: ISOO-MASCC-ASCO Guideline

Journal of Clinical Oncology, ISSN 1527-7755, 0732-183X, Volume 42, 16, Pages 1975-1996, 10.1200/jco.23.02750

Contributors

Peterson, Douglas E [1] Koyfman, Shlomo A [2] Yarom, Noam 0000-0001-9771-7857 [3] [4] Lynggaard, Charlotte Duch 0000-0002-1637-2146 [5] Ismaila, Nofisat [6] Forner, Lone E [7] Fuller, Clifton David 0000-0002-5264-3994 [8] Mowery, Yvonne Marie 0000-0002-9839-2414 [9] [10] Murphy, Barbara A [11] Watson, Erin [12] Yang, David H 0000-0001-8755-1101 [13] Alajbeg, Ivan 0000-0001-8524-5661 [14] Bossi, Paolo 0000-0003-0135-0224 [15] [16] Fritz, Michael A [2] Futran, Neal David [17] Gelblum, Daphna Yael 0000-0001-7211-6246 [18] King, Edward [19] Ruggiero, Salvatore [20] Smith, Derek K [21] Villa, Alessandro 0000-0002-1966-6000 [22] Wu, Jonn S [13] Saunders, Deborah [23]

Affiliations

  1. [1] University of Connecticut Health Center
    2. [NORA names: United States; America, North; OECD];
  2. [2] Cleveland Clinic
    3. [NORA names: United States; America, North; OECD];
  3. [3] Sheba Medical Center
    4. [NORA names: Israel; Asia, Middle East; OECD];
  4. [4] Tel Aviv University
    5. [NORA names: Israel; Asia, Middle East; OECD];
  5. [5] Rigshospitalet
    6. [NORA names: Capital Region of Denmark; Hospital; Denmark; Europe, EU; Nordic; OECD];

Abstract

PURPOSE: To provide evidence-based recommendations for prevention and management of osteoradionecrosis (ORN) of the jaw secondary to head and neck radiation therapy in patients with cancer. METHODS: The International Society of Oral Oncology-Multinational Association for Supportive Care in Cancer (ISOO-MASCC) and ASCO convened a multidisciplinary Expert Panel to evaluate the evidence and formulate recommendations. PubMed, EMBASE, and Cochrane Library databases were searched for randomized controlled trials and observational studies, published between January 1, 2009, and December 1, 2023. The guideline also incorporated systematic reviews conducted by ISOO-MASCC, which included studies published from January 1, 1990, through December 31, 2008. RESULTS: A total of 1,539 publications were initially identified. There were 487 duplicate publications, resulting in 1,052 studies screened by abstract, 104 screened by full text, and 80 included for systematic review evaluation. RECOMMENDATIONS: Due to limitations of available evidence, the guideline relied on informal consensus for some recommendations. Recommendations that were deemed evidence-based with strong evidence by the Expert Panel were those pertaining to best practices in prevention of ORN and surgical management. No recommendation was possible for the utilization of leukocyte- and platelet-rich fibrin or photobiomodulation for prevention of ORN. The use of hyperbaric oxygen in prevention and management of ORN remains largely unjustified, with limited evidence to support its practice.Additional information is available at www.asco.org/head-neck-cancer-guidelines.

Keywords

ASCO, Abstract, Cochrane, Cochrane Library databases, Embase, International, International Society, Library databases, PubMed, cancer, consensus, controlled trials, database, duplicate publications, duplication, evaluation, evidence, evidence-based, evidence-based recommendations, expert panel, experts, fibrin, guidelines, head, head and neck cancer, hyperbaric oxygen, informant consensus, information, leukocyte-, limitations, management, management of osteoradionecrosis, multidisciplinary expert panel, neck, neck cancer, neck radiation therapy, observational study, osteoradionecrosis, oxygen, panel, patients, photobiomodulation, platelet-rich fibrin, practice, prevention, prevention of osteoradionecrosis, publications, radiation, radiation therapy, randomized controlled trials, recommendations, review, review evaluation, study, surgical management, systematic review, systematically review evaluations, therapy, trials, utilization, www

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