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Comparing The Efficacy Of Deferoxamine Or Amifostine Pre-treatment In The Prevention Of Osteoradionecrosis Of The Murine Mandible

Alleyne, B; Varghai, D; Askeroglu, U; Gliniak, C; Tobin, K; Zwiebel, S; Gosain, AK
University Hospitals Case Western Reserve
2013-02-26

Presenter: Brendan J Alleyne

Affidavit:

Director Name: Lisa DiNardo and Hooman Soltanian MD

Presentation Category: Basic Science Research
Abstract Category: Craniomaxillofacial

Introduction: Osteoradionecrosis (ORN) of the facial skeleton is a significant problem for patients who are treated for head and neck cancer. Evidence suggests that deferoxamine (DFO) and amifostine (AMFO) may have beneficial roles in the prevention and treatment of ORN. We hypothesize that DFO and AMFO will have beneficial effects in the prevention and treatment of ORN in a rat model, especially when used in combination.
Method: The right mandible of 40 rats underwent irradiation with 5 fractions of 7 Gy (35 Gy total), the bioequivalent dose to humans treated for cancers of the head and neck. CT scans were taken 6 weeks following the final radiation dose. Image-J (free-ware) was used to calculate the percentage area of decreased calcification within the tooth. Decreased calcification served as a marker for ionizing damage.
Results: The difference between the right central incisor root area and the left was statistically significant for the Radiation-Only Group (p=1.57E-26), the DFO and Radiation Group (p=1.5E-14), and the Combined Drug and Radiation Group (p=2.03E-11). The AMFO and Radiation Group showed the least drastic difference between tooth roots (p=0.00015).
Conclusion: The drug groups all appear to prevent the full manifestation of ORN with the bio-equivalent dose of 35 Gy given over 5 doses. However, AMFO alone appeared to offer greater bone protection by more strongly preventing the observed decalcification. Lastly, these results may implicate areas for further study in radioprotective therapy in which the field overlies the mandible and facial skeleton.

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