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Results
Background
Radiation is widely used as treatment for HNC patients, but invites various acute and chronic
side effects such as diminished healing ability of irradiated bone and subsequent pathological
fractures.
Yield Load
80
100
*
90
70
80
Complications due to radiation in HNC patients place craniofacial reconstruction in high demand
but leave reconstructive surgeons few or no options.
60
70
60
50
Our research aims to improve the viability of Distraction Osteogenesis as a method of bone
reconstruction following radiotherapy, therefore offering a top tier reconstructive option to
surgeons and HNC patients alike.
Failure Load
40
50
40
30
30
20
20
Hypothesis
10
10
0
DO
DFO
DO
XDO
AMF
DFO
Combined
DFO
Combined
900
90
80
70
600
60
700
500
50
400
40
300
30
200
20
100
10
0
DO
XDO
AMF
DFO
Combined
DO
XDO
AMF
Figure 2. Graphs of the biomechanical metrics and bony union rates of the five groups tested.
Rats received a mandibular osteotomy and external fixation device during surgery.
AMF was injected immediately prior to XRT and DFO was injected directly into the fracture site
every other day starting POD 4.
Combined
1000
N/mm
Sprague Dawley rats (n=58) were divided into five groups: non-irradiated distraction (DO),
radiated distraction (XDO), radiated distraction with amifostine (AMF), radiated distraction with
deferoxamine (DFO), and radiated distraction with both therapies (Combined).
AMF
Stiffness
800
Methods
XDO
Condyle
Molars
Incisor
DO
XRT/DO
DFO
Combined
Mandibles were potted and loaded to failure to test biomechanical strength (yield load, failure
load and stiffness)
AMF
Figure 1. Experimental timeline represents sequence and timing of therapies and procedures.
Conclusions
This combined therapy has immense potential in the clinical cases of over 50,000 head and neck cancer patients each year. A
combined AMF/DFO treatment preserves DO as a viable method of bone regeneration following radiotherapy, therefore filling
the current void of reconstructive options for HNC patients and reconstructive surgeons. Additional metrics of bone healing
will be investigated in the future to further support the benefits of a combined therapy.
Acknowledgements
This work was supported by NIH R01
CA 125187-06 to SR Buchman
The authors thank Yekaterina
Polyatskaya, Noah Nelson, and Steven
Buchman for mentorship and support