Role of Steroids in Preventing Osteoradionecrosis of the Head and Neck: A Systematic Review Article

Full Text via DOI: 10.1177/0003489419826595 PMID: 30688080 Web of Science: 000465138200010

Cited authors

  • Raggio, Blake S.; Winters, Ryan D.


  • Objective: The aim of this study was to summarize the effectiveness of steroids in the prevention of osteoradionecrosis of the head and neck.; Data Sources: PubMED, MEDLINE, Embase, Google Scholar, and Cochrane trial registries.; Methods: A systematic review of these data sources was performed through September 2018 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included were English-language studies evaluating patients of all age groups diagnosed with head and neck cancer who underwent radiation therapy while receiving peritreatment steroids compared with those who did not receive steroids.; Results: Two retrospective cohort studies were identified for qualitative review. On the basis of analysis of 25 328 participants (36-82 years of age) with head and neck cancer who underwent radiation therapy, the use of peritreatment steroids was associated with a significantly lower risk for osteoradionecrosis in both studies, with a hazard ratio of 0.74 (95% confidence interval, 0.59-0.94; P = .012) and a relative risk of 0.04 (95% confidence interval, 0.003-0.560; P = .017). Meta-analysis was precluded by clinical and statistical heterogeneity. Overall, the studies were of limited quality with high risk for bias and poor methodology.; Conclusions: Limited retrospective data suggest that steroids are predictive of a reduced risk for osteoradionecrosis; however, no definitive conclusions can be made given the poor quality of the available literature. Well-designed, comparison-controlled trials are needed to clarify the promising role of steroids in the prevention of osteoradionecrosis of the head and neck.

Publication date

  • 2019

International Standard Serial Number (ISSN)

  • 0003-4894

Start page

  • 441

End page

  • 446


  • 128


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