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Cost analysis of osteoradionecrosis

  • L Park (a1), N Lilic (a2), B Addison (a3) and R Patel (a2)



Osteoradionecrosis is a significant complication of head and neck cancer treatment, and its most severe form (grade III) necessitates radical surgery. This study aimed to compare the cost of free-flap reconstructive surgery for grade III osteoradionecrosis and similar non-osteoradionecrosis cases in order to assess the cost burden of osteoradionecrosis treatment.


All patients who underwent free-flap reconstructive surgery for osteoradionecrosis between July 2004 and July 2010 at Auckland City Hospital (19 patients) were identified, and relevant data were collected retrospectively. These patients were matched in terms of age and sex with patients who underwent free-flap reconstructive surgery.


The treatment cost was 44 per cent higher in osteoradionecrosis patients when compared to non-osteoradionecrosis patients.


The significant financial burden on the health system, and the growing evidence for the effectiveness of pentoxifylline, tocopherol and clodronate, should prompt us to explore this alternative treatment further.


Corresponding author

Address for correspondence: Ms Lydia Park, 7 Dexter Avenue, Mount Eden, Auckland, New Zealand Fax: +64 9 631 0716 E-mail:


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1 Madrid, C, Abarca, M, Bouferrache, K. Osteoradionecrosis: an update. Oral Oncol 2010;46:471–4
2 Marx, RE. Osteoradionecrosis: a new concept of its pathophysiology. J Oral Maxillofac Surg 1983;41:283–8
3 Delanian, S, Lefaix, JL. The radiation-induced fibroatrophic process: therapeutic perspective via the antioxidant pathway. Radiother Oncol 2004;73:119–31
4 Pitak-Arnnop, P, Sader, R, Dhanuthai, K, Masaratana, P, Bertolus, C, Chaine, A et al. Management of osteoradionecrosis of the jaws: an analysis of evidence. Eur J Surg Oncol 2008;34:1123–34
5 Annane, D. Hyperbaric oxygen therapy for radionecrosis of the jaw: a randomized, placebo-controlled, double-blind trial from the ORN96 study group. J Clin Oncol 2004;22:4893–900
6 Dion, MW, Hussey, DH, Doornbos, JF, Vigliotti, AP, Wen, BC, Anderson, B. Preliminary results of a pilot study of pentoxifylline in the treatment of late radiation soft tissue necrosis. Int J Radiat Oncol Biol Phys 1990;19:401–7
7 Delanian, S, Depondt, J, Lefaix, JL. Major healing of refractory mandible osteoradionecrosis after treatment combining pentoxifylline and tocopherol: a phase II trial. Head Neck 2005;27:114–23
8 Delanian, S, Chatel, C, Porcher, R, Depondt, J, Lefaix, JL. Complete restoration of refractory mandibular osteoradionecrosis by prolonged treatment with a pentoxifylline-tocopherol-clodronate combination (PENTOCLO): a phase II trial. Int J Radiat Oncol Biol Phys 2011;80:832–9
9 Cannady, SB, Dean, N, Kroeker, A, Albert, T, Rosenthal, E, Wax, M. Free flap reconstruction for osteoradionecrosis of the jaws – outcomes and predictive factors for success. Head Neck 2011;33:424–8
10 Kelishadi, SS, St-Hilaire, H, Rodriquez, ED. Is simultaneous surgical management of advanced craniofacial osteoradionecrosis cost-effective? Plast Reconstr Surg 2009;123:1010–17
11 Smith, GC, Pell, JP. Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials. BMJ 2003;327:1459
12 Potts, M, Prata, N, Walsh, J, Grossman, A. Parachute approach to evidence based medicine. BMJ 2006;333:701–3


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Cost analysis of osteoradionecrosis

  • L Park (a1), N Lilic (a2), B Addison (a3) and R Patel (a2)


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