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A systematic review and meta-analysis of osteoradionecrosis following proton therapy in patients with head and neck cancer.

Author information

Affiliations

  • 1. Department of Otorhinolaryngology, Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
      Authors
    • Chiu KW 1
    (1 author)
  • 2. Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
      Authors
    • Yu TP 2
    (1 author)
  • 3. Department of Radiation Oncology, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan, ROC.
      Authors
    • Kao YS 3
    (1 author)

Oral Oncology, 29 Nov 2023, 148:106649
https://doi.org/10.1016/j.oraloncology.2023.106649 PMID: 38035508 

Review

Abstract 

Introduction

Head and neck cancer ranks as the seventh most common cancer worldwide. Proton therapy is widely used in head and neck cancer. Osteoradionecrosis(ORN) is currently a commonly investigated side effect of proton therapy. A meta-analysis is needed to investigate this topic.

Material/methods

Two authors searched three databases, including PubMed, Embase, and Cochrane Library; the search period was from inception to June 2023. The search keyword was set to be ((("osteoradionecrosis") OR ("osteonecrosis")) AND ("proton")).

Results

We initially collected 410 articles, and after article selections, 22 articles remained in our systematic reviews. Due to the overlapping of patient populations, 17 studies were finally included in our meta-analysis. The pooled grade 3 or more ORN rate is 0.01(95 % CI = 0.01-0.03). Subgroup analysis showed that IMPT didn't reduce grade 3 or more ORN compared with 3DCPT (p = 0.15).

Conclusions

Our meta-analysis showed that severe ORN rarely occurred in proton therapy for head and neck cancer patients.

Full text links 

Read article at publisher's site: https://doi.org/10.1016/j.oraloncology.2023.106649

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