Translational treatment paradigm for managing non-unions secondary to radiation injury utilizing adipose derived stem cells and angiogenic therapy

Head Neck. 2016 Apr;38 Suppl 1(Suppl 1):E837-43. doi: 10.1002/hed.24110. Epub 2015 Jul 15.


Background: Bony non-unions arising in the aftermath of collateral radiation injury are commonly managed with vascularized free tissue transfers. Unfortunately, these procedures are invasive and fraught with attendant morbidities. This study investigated a novel, alternative treatment paradigm utilizing adipose-derived stem cells (ASCs) combined with angiogenic deferoxamine (DFO) in the rat mandible.

Methods: Rats were exposed to a bioequivalent dose of radiation and mandibular osteotomy. Those exhibiting non-unions were subsequently treated with surgical debridement alone or debridement plus combination therapy. Radiographic and biomechanical outcomes were assessed after healing.

Results: Significant increases in biomechanical strength and radiographic metrics were observed in response to combination therapy (p < .05). Importantly, combined therapy enabled a 65% reduction in persisting non-unions when compared to debridement alone.

Conclusion: We support the continued investigation of this promising combination therapy in its potential translation for the management of radiation-induced bony pathology. © 2015 Wiley Periodicals, Inc. Head Neck 38: E837-E843, 2016.

Keywords: adipose-derived stromal cell; deferoxamine; osteoradionecrosis; pathologic fracture; radiotherapy.

MeSH terms

  • Adipose Tissue / cytology*
  • Animals
  • Debridement
  • Deferoxamine / pharmacology*
  • Fractures, Ununited
  • Mandible / radiation effects
  • Mandible / surgery*
  • Radiation Injuries / therapy*
  • Rats
  • Rats, Sprague-Dawley
  • Stem Cell Transplantation*
  • Stem Cells / cytology


  • Deferoxamine