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Volume 19, Number 4, December 2007

Mandibular Osteoradiomyelitis after Successive Superselective Intra-arterial Chemotherapy Concurrent with Radiotherapy in Advanced Oral Cancers: Report of 2 Cases


Beng Gwan Teh, Wataru Kobayashi, Hisashi Sato, Hiroto Kimura
Department of Oral and Maxillofacial Surgery, Hirosaki University School of Medicine, Aomori, Japan

Abstract 
Superselective intra-arterial chemotherapy concurrent with radiotherapy has been reported to be an effective treatment for head and neck cancers, especially in inoperable advanced cases; however, very few papers report the severe post-treatment complications associated with the treatment modality. Nine patients with advanced oral cancers were treated by superselective intra-arterial chemotherapy concurrent with radiotherapy since 2003, and 2 of these developed severe osteoradiomyelitis of the mandible. One patient underwent a free fibular osteocutaneous flap reconstruction of the mandible 18 months post-treatment. We conclude that superselective intra-arterial chemoradiotherapy is effective, but the associated severe complications of osteoradiomyelitis or osteoradionecrosis need to be addressed.

Key words: Combined modality therapy, Mouth neoplasms, Osteoradionecrosis, Radiation injuries

Asian J Oral Maxillofac Surg. 2007;19:210-214.

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