TY - JOUR

T1 - Mesenchymal Stem Cell Therapy for Osteoradionecrosis of the Mandible

T2 - a Systematic Review of Preclinical and Human Studies

AU - Gundestrup, Anders Kierkegaard

AU - Lynggaard, Charlotte Duch

AU - Forner, Lone

AU - Heino, Terhi J.

AU - Jakobsen, Kathrine Kronberg

AU - Fischer-Nielsen, Anne

AU - Grønhøj, Christian

AU - von Buchwald, Christian

PY - 2020

Y1 - 2020

N2 - Background: Osteoradionecrosis (ORN) of the mandible is a severe complication of radiotherapy for head and neck cancer and is arduously difficult to manage. Current treatment options carry risks with some patients remaining incurable. Mesenchymal stromal/stem cell (MSC) therapy has shown promising results supporting osteogenesis and regeneration of radiotherapy-damaged tissues. The aim of this study was to systematically review the literature on the safety and efficacy of MSCs in treating ORN. Methods: A systematic search was performed on MEDLINE, Embase, Cochranes Library online databases, and clinicaltrials.gov to identify preclinical and clinical studies examining the effect of MSCs on osseous healing of ORN. The preclinical studies were assessed according to the SYRCLEs guidelines and risk of bias tool. Results: Six studies (n = 142) from 5 countries were eligible for analysis. Of these four were preclinical studies and two clinical case studies. Preclinical studies found MSC treatment to be safe, demonstrating bone restorative effects and improved soft tissue regeneration. In the clinical cases, healing of bone and soft tissue was reported with no serious adverse events. Conclusion: The evidence from the included studies suggests that MSCs may have beneficial regenerative effects on the healing of ORN. None of the studies reported adverse events with the use of MSCs. More carefully controlled studies with well-identified cells are however needed to demonstrate the efficacy of MSCs in a clinical setting. Graphical abstract[Figure not available: see fulltext.]

AB - Background: Osteoradionecrosis (ORN) of the mandible is a severe complication of radiotherapy for head and neck cancer and is arduously difficult to manage. Current treatment options carry risks with some patients remaining incurable. Mesenchymal stromal/stem cell (MSC) therapy has shown promising results supporting osteogenesis and regeneration of radiotherapy-damaged tissues. The aim of this study was to systematically review the literature on the safety and efficacy of MSCs in treating ORN. Methods: A systematic search was performed on MEDLINE, Embase, Cochranes Library online databases, and clinicaltrials.gov to identify preclinical and clinical studies examining the effect of MSCs on osseous healing of ORN. The preclinical studies were assessed according to the SYRCLEs guidelines and risk of bias tool. Results: Six studies (n = 142) from 5 countries were eligible for analysis. Of these four were preclinical studies and two clinical case studies. Preclinical studies found MSC treatment to be safe, demonstrating bone restorative effects and improved soft tissue regeneration. In the clinical cases, healing of bone and soft tissue was reported with no serious adverse events. Conclusion: The evidence from the included studies suggests that MSCs may have beneficial regenerative effects on the healing of ORN. None of the studies reported adverse events with the use of MSCs. More carefully controlled studies with well-identified cells are however needed to demonstrate the efficacy of MSCs in a clinical setting. Graphical abstract[Figure not available: see fulltext.]

KW - Cell therapy

KW - Mesenchymal stem cells

KW - ORN

KW - Osteoradionecrosis

KW - Systematic review

U2 - 10.1007/s12015-020-10034-5

DO - 10.1007/s12015-020-10034-5

M3 - Review

C2 - 32869179

AN - SCOPUS:85090062380

VL - 16

SP - 1208

EP - 1221

JO - Stem Cell Reviews and Reports

JF - Stem Cell Reviews and Reports

SN - 2629-3269

IS - 6

ER -