What risk of osteoradionecrosis (ORN) do you quote patients receiving head and neck radiation? It largely boils down to how you define it, and this review is here to help you do that. Most conservatively, ORN is diagnosed clinically with observation of symptomatic bone necrosis (typically the mandible) occurring with a radiation field that does not heal for at least 3-6 months. Proponents of this definition say this captures clinically-meaningful cases. Others propose including radiographic and/or histologic criteria, which of course broadens the incidence and may well include cases patients don’t care about unless there is a way to meaningfully intervene. Using historic definitions, 70% of ORN occurs within 2-3 years and 77% in an area receiving 70+ Gy. | Yang, Pract Radiat Oncol 2024
