Osteoradionecrosis of the maxillary-orbital complex after neutron beam radiotherapy

OBJECTIVE: Neutron beam radiotherapy (NRT) has been advocated for treatment of malignant salivary gland tumors and adenoid cystic carcinoma of the par anasal sinuses. The purpose of this study is to determine whether primary o r adjuvant NRT results in a significantly increased rate of osteoradionecro sis (ORN) of the maxillary-orbital complex (MOC), STUDY DESIGN AND SETTING: Ail 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). RESULTS: 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. CONCLUSION: The reported trend of ORN after definitive surgery and NRT show s a markedly increased complication rate. SIGNIFICANCE: The use of adjuvant NRT after definitive surgical resection i nvolving the MOC should be considered with great caution.