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Table 3 Grade 1-4 RON in 21/356 patients at risk (oropharynx or oral cavity tumors irradiated with >60Gy to the mandible): 5 with grade 3/4 RON, 3/5 following invasive procedures post-IMRT

From: Late term tolerance in head neck cancer patients irradiated in the IMRT era

RON, initial G RON therapy (n) Outcome(n): G Complications(n) following RON therapy: final G Onset post IMRT months IMRT sequence
G1-2 no therapy, spontaneous healing (2) G0 None: G0 5/21 2 definitive
debridment + antibiotics (4)* ad integrum healing (4/4): G0 None: G0 5/6/12 3 postop, 1 definitive
G2-3 partial decortication (11)** ad integrum healing (10/11)**: G0 pathol. fracture, chronic infection (1/11): G4 3 (0-12) 6 postop, 5 definitive
G3 partial mandibulectomy (4) ad integrum healing (1): G3 pathol. fracture (1/4) ***: G4 6/6/18/28*** 3 postop***, 1 definitive
osteomyelitis (1/4) ***: G4
osteocutaneous fistula (1/4)***: G4
  1. *: 2/4 with several previous reconstructive soft tissue operations, dental implants with consecutive bone fracture, followed by superficial RON.
  2. **: 2/11 RON following tooth extraction post-IMRT, 1/11 operated patient with pre-IMRT wound revisions/soft tissue debridement, 1/11 with RON following pre-IMRT dental care tooth extraction.
  3. ***: 3/4 RON following dental implants and/or other reconstructive surgery post-IMRT.