Evaluating the impact of patient, tumor, and treatment characteristics on the development of jaw complications in patients treated for oral cancers: A SEER-Medicare analysis

Background Jaw complications, including osteoradionecrosis, are significant sequelae of radiation therapy (RT) for oral cancers. This study identifies the impact of patient, tumor, and treatment characteristics on the development of jaw complications in patients treated with RT. Methods The Surveill...

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Bibliographic Details
Published in:Head & neck 2013-11, Vol.35 (11), p.1599-1605
Main Authors: Beadle, Beth M., Liao, Kai-Ping, Chambers, Mark S., Elting, Linda S., Buchholz, Thomas A., Kian Ang, K., Garden, Adam S., Guadagnolo, B. Ashleigh
Format: Article
Language:English
Subjects:
Age Distribution
Aged
Chi-Square Distribution
Cohort Studies
Confidence Intervals
Databases, Factual
Female
Follow-Up Studies
head and neck radiation
Humans
IMRT
Incidence
Jaw - radiation effects
jaw complications
Male
Medicare - statistics & numerical data
Mouth Neoplasms - mortality
Mouth Neoplasms - pathology
Mouth Neoplasms - radiotherapy
Neoplasm Invasiveness - pathology
Neoplasm Staging
osteoradionecrosis
Osteoradionecrosis - diagnosis
Osteoradionecrosis - epidemiology
Proportional Hazards Models
Radiotherapy Dosage
Radiotherapy, Intensity-Modulated - adverse effects
Radiotherapy, Intensity-Modulated - methods
Retrospective Studies
Risk Assessment
SEER Program
SEER-Medicare
Sex Distribution
United States
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Summary:Background Jaw complications, including osteoradionecrosis, are significant sequelae of radiation therapy (RT) for oral cancers. This study identifies the impact of patient, tumor, and treatment characteristics on the development of jaw complications in patients treated with RT. Methods The Surveillance, Epidemiology, and End Results (SEER)–Medicare database was used to identify patients treated with RT for oral cancers from 1999 to 2007. Jaw complications were identified by International Classification of Diseases 9th revision (ICD‐9) diagnosis codes and/or related procedures using Current Procedural Terminology (CPT) and ICD‐9 codes. Results A total of 1848 patients were identified. With a median follow‐up of 2.5 years, 297 patients (16.1%) developed jaw complications: 226 patients had a diagnosis, 41 patients had a procedure, and 30 patients had both. On multivariate analysis, female sex, lack of chemotherapy use, and fewer comorbidities were associated with a statistically significant increase in jaw complications. Conclusions Even with modern techniques, jaw complications are a notable and potentially devastating side effect of RT for oral cancers. © 2012 Wiley Periodicals, Inc. Head Neck, 35: 1599–1605, 2013
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.23205