Assessment of the impact of osteoradionecrosis on quality-of-life measures in patients with head and neck cancer

Abstract

Osteoradionecrosis of the jaws is a serious complication of radiotherapy that frequently results in facial deformity, pain, fracture, devitalized bone, fistulas, dysesthesia or anesthesia, trismus, difficulty chewing, swallowing, and localized or systemic infections. Osteoradionecrosis is defined as “a potentially severe, delayed radiation-induced injury characterized by bone necrosis, failure to heal, and exposed bone for at least three months in the absence of primary tumor progression or recurrence, or metastatic disease”. The incidence rate of osteonecrosis among patients with head and neck cancers treated with radiotherapy or concurrent chemo-radiotherapy is 2–22%. Although the incidence of osteoradionecrosis of the jaws has decreased as a result of recent improvements in radiotherapy procedures, it is still a very challenging task to predict, prevent, and treat osteoradionecrosis of the jaws and its consequences on patients’ quality of life. Despite the negative impacts of osteoradionecrosis of the jaws on sufferers’ physical appearance and functioning, and social relationships, there is a paucity of research on the quality-of-life that is specific to this condition. This chapter provides a summary of the available data on the physical, social, and emotional effects of osteoradionecrosis of the jaws as determined by general or head and neck cancer-specific quality of life surveys, which may be used to evaluate and treat such patients in radiation oncology and dentistry practices.