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

AI Article Synopsis

  • - The text outlines evidence-based recommendations for preventing and managing osteoradionecrosis (ORN) of the jaw in cancer patients who have undergone head and neck radiation therapy.
  • - A multidisciplinary Expert Panel from ISOO-MASCC and ASCO reviewed over 1,500 studies from various medical databases to create these guidelines, identifying a total of 80 studies suitable for systematic review evaluation.
  • - Key findings include strong evidence-based recommendations for prevention and surgical management of ORN, while the effectiveness of hyperbaric oxygen treatment and other methods like leukocyte-rich fibrin for ORN prevention remains unsupported by sufficient evidence.

Article 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.

Download full-text PDF

Source
http://dx.doi.org/10.1200/JCO.23.02750DOI Listing

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