PMID: 11899674Mar 20, 2002Paper

Mature bone radionecrosis: from recent physiopathological knowledge to an innovative therapeutic action

Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
Sylvie Delanian, J L Lefaix

Abstract

Osteoradionecrosis is a severe radiotherapy (RT) injury by healing failure, late effect and spontaneously irreversible by tissue death. Histologically, it consists in a pagetoid mosaic that combines a defective osteogenesis with an osteoclastic osteolysis and more marginally an osteolytic osteolysis, turned to account to fibroblastic and collagenic fibrosis. Several pathogenic hypotheses favor sometimes a vascular hypoxic hypotheses, sometimes a fibro-atrophic hypothesis. Various events start up or favour ORN as traumatisms (dental extraction, surgery,...) or bacterian infection on fistula. In clinic, adult mature bone concerned is the mandible after head and neck RT by septic ORN, and the hip after pelvic RT by aseptic ORN. For each, epidemiology, clinic and therapeutic aspects are developed. Usual therapeutic attitudes consisted in restriction of defavorable associated events (dental extraction, infection, RT dose, chemotherapy,...) and devitalized tissue removal. Physiopathological therapeutic innovatives aspects are proposed to struggle against radiation-induced fibrosis associated and to limit bone destruction.

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Citations

Jan 15, 2015·Radiation Research·Yannick SaintignyJean-Louis Lefaix
Nov 21, 2019·The Laryngoscope·Alexis DissardNicolas Saroul
Nov 3, 2004·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Djillali AnnaneSylvie Chevret
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May 25, 2010·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Jacques Bessereau, Djillali Annane

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