Osteoradionecrosis of the maxillary-orbital complex after neutron beam radiotherapy.

Abstract

Neutron beam radiotherapy (NRT) has been advocated for treatment of malignant salivary gland tumors and adenoid cystic carcinoma of the paranasal sinuses. The purpose of this study is to determine whether primary or adjuvant NRT results in a significantly increased rate of osteora-dionecrosis (ORN) of the maxillary-orbital complex (MOC). All patients who received primary or adjuvant NRT involving the MOC and/or maxillofacial prosthetic rehabilitation at Wayne State University from 1992 to 1997 were evaluated (n = 9). ORN did not develop in any of the 5 patients who received primary NRT. All 4 patients who received adjuvant NRT after surgical resection had ORN involving the MOC within the irradiated fields. The reported trend of ORN after definitive surgery and NRT shows a markedly increased complication rate. The use of adjuvant NRT after definitive surgical resection involving the MOC should be considered with great caution.