Overview
Metastatic malignant neoplasm to the jaw refers to cancer that has spread from its primary site to the bones of the jaw. This can present as a secondary complication in patients with head and neck cancers treated with radiation therapy, potentially leading to osteoradionecrosis (ORN) 1.Diagnosis
Diagnosis is typically based on clinical presentation, imaging (e.g., CT, MRI, bone scan), and biopsy confirmation of metastatic disease 1.
In the context of head and neck cancer treated with radiation, the development of ORN should be considered in the differential diagnosis of jaw pain, swelling, or non-healing ulcers 1.Management
Management strategies for ORN secondary to head and neck radiation therapy focus on prevention and surgical intervention 1.
Specific recommendations for the utilization of leukocyte- and platelet-rich fibrin or photobiomodulation for ORN prevention were not possible due to limited evidence 1.
The role of hyperbaric oxygen in the prevention and management of ORN is still under consideration 1.Key Recommendations
Recommendations pertaining to best practices in the prevention of ORN and surgical management are considered evidence-based with strong evidence 1.
No recommendation could be made regarding the use of leukocyte- and platelet-rich fibrin for ORN prevention 1.
No recommendation could be made regarding the use of photobiomodulation for ORN prevention 1.
The use of hyperbaric oxygen in the prevention and management of ORN remains a topic of ongoing discussion 1.References
1 Peterson DE, Koyfman SA, Yarom N, Lynggaard CD, Ismaila N, Forner LE et al.. Prevention and Management of Osteoradionecrosis in Patients With Head and Neck Cancer Treated With Radiation Therapy: ISOO-MASCC-ASCO Guideline. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2024. link