Mandibular Osteoradiomyelitis after Successive Superselective Intra-arterial Chemotherapy Concurrent with Radiotherapy in Advanced Oral Cancers: Report of 2 Cases

Superselective intra-arterial chemotherapy concurrent with radiotherapy has been reported to be an effective treatment for head and neck cancers, especially in inoperable advanced cases; however, very few papers report the severe post-treatment complications associated with the treatment modality. Nine patients with advanced oral cancers were treated by superselective intra-arterial chemotherapy concurrent with radiotherapy since 2003, and 2 of these developed severe osteoradiomyelitis of the mandible. One patient underwent a free fibular osteocutaneous flap reconstruction of the mandible 18 months post-treatment. We conclude that superselective intra-arterial chemoradiotherapy is effective, but the associated severe complications of osteoradiomyelitis or osteoradionecrosis need to be addressed.