Multi-institutional Normal Tissue Complication Probability (NTCP) Prediction Model for Mandibular Osteoradionecrosis: Results from the PREDMORN Study

作者：L. Humbert-Vidan, Christian Rønn Hansen, Steven Petit, Carles Muñoz-Montplet, Katrina Hueniken, Abdallah S. R. Mohamed, Deborah Saunders, Vinod F. Patel, Gerda M. Verduijn, Wilma D Heemsbergen, A. van der Schaaf, Max Witjes, Suzanne P.M. de Vette, Mohammad Moharrami, Abdul Ahad Khan, Jordi Marruecos Querol, Irene Oliveras Cancio, Mike Oliver, Peter B. Reich, Stacey A. Santi, Andrew Pearce, Stephen Y. Lai, Andrew P. King, Ali Hosni, Andrew Hope, Erin Watson, Johannes A. Langendijk, Jørgen Johansen, Amy C. Moreno, Clifton D. Fuller, Lisanne V. van Dijk, Teresa Guerrero Urbano · 发表于：International Journal of Radiation Oncology*Biology*Physics · 年份：2026 · DOI：10.1016/j.ijrobp.2025.12.044 · 被引用次数：3 · 研究领域：Oral health in cancer treatment、Dental Radiography and Imaging、Head and Neck Cancer Studies

PURPOSE: Mandibular osteoradionecrosis (ORN) is a severe late complication affecting patients with head and neck cancer (HNC) treated with radiation therapy (RT) that significantly impacts patients' quality of life and can require costly interventions. Although radiation dose is a key factor, other clinical and demographic risk factors also influence ORN development. Previous predictive models have primarily been single-institutional, limiting their generalizability. In this first analysis from the PREDMORN Consortium, we have aimed to reproduce existing statistical association and modeling analyses on the largest and most diverse mandibular ORN cohort worldwide to allow comparison with previous studies. METHODS AND MATERIALS: This retrospective multi-institutional study included 3928 patients with HNC (622 ORN cases) from 8 institutions. Clinical, demographic, and dosimetric variables were analyzed to develop a prediction model (any grade ORN vs no ORN) using forward stepwise logistic regression with correlation-based variable preselection. The ORN normal tissue complication probability (NTCP) model was developed on 80% of data from 6 institutions, tested on the remaining unseen 20%, and externally validated on a matched cohort (58 patients, 19 ORN cases) and a large population-based cohort (2687 patients, 215 ORN cases). RESULTS: , pre-RT dental extractions, and smoking status. The ORN NTCP model demonstrated very good calibration on the population-based external cohort (Br...