A research team in the department of oral medicine at Carolinas Medical Center in Charlotte, NC, has been awarded an $8 million National Institutes of Health (NIH) grant to study dental and oral medicine outcomes of patients who have received high-dose radiation to the head and neck region.
Each year, 40,000 people in the U.S. develop head and neck cancer, and many have to receive high-dose radiation therapy, often in combination with surgery and/or chemotherapy, the medical center noted. An unavoidable side effect of radiation therapy is damage to the oral and maxillofacial tissues, some of which persists for the lifetime of the patient. These side effects include a permanent decrease in saliva production (hyposalivation), along with impaired bone healing, leading to a lifelong risk of osteoradionecrosis (ORN).
It is felt that approximately 50% of all ORN cases are associated with dental extractions following radiation therapy, yet these patients are caught in a vicious cycle as they are at a high risk of needing dental extractions, according to Michael Brennan, DDS, MHS, principal investigator of the NIH study.
"Currently, dental management of these patients is largely based on expert opinion and there are no evidence-based guidelines available to inform the healthcare team who manages patients before or after radiation therapy," Dr. Brennan said in a press release. "The data we collect will lead to a better understanding of the oral and dental sequelae experienced by these patients after radiation therapy, which will lead to protocols for patients with head and neck cancer that are based on data from this five-year study."
Head and neck cancer patients enrolled in this multicenter study will receive a standard dental assessment prior to radiation therapy, with detailed documentation of dental/oral conditions and dental management at that time. Follow-up visits will be conducted every six months for up to two years for the entire study population. Tooth loss will be documented and secondary analyses will look for risk factors for tooth loss.
In addition to Carolinas Medical Center, patients will be enrolled at Harvard University, University of Pennsylvania, New York University, and the University of Connecticut. Dr. Brennan will work closely with Dr. Rajesh Lalla, principle investigator at the University of Connecticut. The University of Minnesota will serve as the data coordinating center for this study.
