Customized mouthpieces designed to reduce tongue mucositis in carbon-ion radiotherapy for tumors of the nasal and paranasal sinuses

Saitoh, Jun‐ichi; Shirai, Katsuyuki; Kubota, Yoshiki; Shimada, Hirofumi; Abe, Takanori; Komatsu, Yuka; Komatsu, S; Ohno, Tatsuya; Nakano, Takashi; Yokoo, Satoshi

doi:10.1016/j.phro.2017.07.003

Cited by 17 publications

(34 citation statements)

References 10 publications

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“…Decreasing the RT dose was noted, but the reproducibility of such a dose decrease should be a concern [17]. Musha et al declared decreased radiation-induced mucositis with the use of a customized bite block for carbon-ion RT [18]. Kudoh et al stated the effectiveness of water-equivalent bite blocks during external beam RT for oral cancer.…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Printed Silicone Bite Blocks for Radiotherapy of Head and Neck Cancer—A Preliminary Study

et al. 2020

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Conventional methods that have been developed to immobilize the mouth and tongue for radiotherapy (RT) in head and neck cancer (HNC) treatment have been unsatisfactory. We, therefore, developed three-dimensional (3D), customizable, silicone bite blocks and examined their clinical feasibility. For HNC patients, before RT, the 3D printed bite blocks were fabricated based on primary computed tomography (CT) simulation images. The placement of the 3D bite blocks was followed by a secondary CT simulation before RT planning was finalized. Dosimetric parameters and positioning verification achieved with the propose bite blocks were compared with conventional universal oral corks. The 3D printed bite blocks were conformal to the occlusal surface, ensuring immobilization of the tongue without eliciting a gag reflex, and an elastic and firm texture that supports opening of the mouth, with a smooth surface with tolerable intraoral tactility. The dosimetry of patients using the proposed bite blocks showed better coverage of the planning target volume and surface of a tumour bed along with reduction in normal tissue doses. Good concordance of positioning by 3D printed bite blocks during the RT course was verified. The 3D printed bite blocks with silicone might be a customizable, safe, and practical advanced technology in RT for HNC.

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Section: Discussionmentioning

confidence: 99%

Three-Dimensional Printed Silicone Bite Blocks for Radiotherapy of Head and Neck Cancer—A Preliminary Study

et al. 2020

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“…In all patients with highly advanced tumor who were expected to develop high‐grade adverse events, careful and adequate explanation was given repeatedly and informed consent was obtained prior to the treatment. Recently, much effort has been made to reduce adverse events . For example, we identified the optimal cutoff dose constraints for predicting the occurrence of brain necrosis by analysis of past cases and the dose constraints might help minimize brainstem necrosis after C‐ion RT .…”

Section: Discussionmentioning

confidence: 99%

A multi‐institutional retrospective study of carbon‐ion radiotherapy for non‐squamous cell malignant tumors of the nasopharynx: Subanalysis of Japan Carbon‐Ion Radiation Oncology Study Group study 1402 HN

et al. 2018

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BackgroundThis multi‐institutional retrospective study focused on the clinical outcome of carbon‐ion radiotherapy (C‐ion RT) for non‐squamous cell malignant tumors of the nasopharynx.MethodsThe Japan Carbon‐ion Radiation Oncology Study Group collected and analyzed data for 43 patients with non‐squamous cell malignant tumors of the nasopharynx treated with C‐ion RT at four institutions in Japan.ResultsTwenty‐nine patients had adenoid cystic carcinomas, seven had malignant melanomas, three had adenocarcinomas, two had mucoepidermoid carcinomas, and two had other pathologies. Twenty‐six of the 43 patients (61%) had T4 tumors. The most common dose‐fractionation schedule was 64 Gy (relative biological effectiveness) in 16 fractions. The median follow‐up period was 30 months. The 2‐year local control (LC) and overall survival (OS) rates were 88% and 84%, respectively. For late toxicity, one patient developed grade 4 optic nerve disorder and two developed grade 5 pharyngeal hemorrhage. Actual incidence of grade 3 or higher late adverse events was 19%, and included cranial nerve dysfunction, jaw bone necrosis, central nervous system necrosis, and ear inflammation.ConclusionsC‐ion RT provided good LC and OS rates with acceptable toxicity for treatment of non‐squamous cell malignant tumors of the nasopharynx.

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“…Mouthpieces are widely used for occlusal fixation and tongue retraction in head and neck radiotherapy, and their usefulness has been widely reported [1][2][3][4][5]. Furthermore, the effectiveness of a newly developed water-equivalent mouthpiece during external beam radiotherapy for oral cancer has been described [4].…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, the effectiveness of a newly developed water-equivalent mouthpiece during external beam radiotherapy for oral cancer has been described [4]. In external beam radiotherapy for cancer in the tongue, floor of the mouth, and lower gingiva, mouthpieces can reduce the radiation dose to the upper gingiva or hard palate by keeping the mouth open [2,3]. Mouthpieces can also immobilize the tongue, which is important when treating patients with tongue cancer using external beam radiotherapy [4,5].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of mouthpiece fixation devices for head and neck radiotherapy patients fabricated in PolyJet photopolymer by a 3D printer

et al. 2019

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The purpose of our study was to evaluate the usefulness of a biocompatible class VI resin PolyJet photopolymer Objet MED610 (MED610)-made mouthpiece fabricated using a 3D printer as a fixation device for head and neck radiotherapy patients. Methods: Five mouthpieces made of GC Exafine putty type (GCEP) were fabricated from five dry skull bones. After computed tomography reconstruction of the GCEP-made mouthpiece and its surface extraction, the MED610-made mouthpieces were replicated. The sizes of the GCEP and MED610 mouthpieces were measured with a vernier caliper in width, length, and height, respectively. The volumes of these mouthpieces were measured by Archimedes' principle using pure water. For dose evaluation, the GCEP and MED610 mouthpieces were placed in the same part of a water phantom, and a 4-MV X-ray beam was located at the left maxillary gingiva, buccal mucosa, and oral floor. The dose for the planning target volume (PTV) was evaluated. Results: The differences in the mean size and volume between the GCEP and MED610 mouthpieces were 0.03 mm and 0.21 cm 3 , respectively. Compared with the conventional GCEP mouthpiece, the dose absorption in the MED610 mouthpiece was closer to that in only water. When the mouthpiece was within the PTV margin, the minimum coverage dose at 95% of the PTV increased by 2.4% in the maxillary gingiva and by 3.6% in the buccal mucosa. Conclusion: A 3D printer can construct a mouthpiece accurately. The MED610 mouthpiece is suitable for use in dosimetry in head and neck radiotherapy.

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Customized mouthpieces designed to reduce tongue mucositis in carbon-ion radiotherapy for tumors of the nasal and paranasal sinuses

Cited by 17 publications

References 10 publications

Three-Dimensional Printed Silicone Bite Blocks for Radiotherapy of Head and Neck Cancer—A Preliminary Study

Three-Dimensional Printed Silicone Bite Blocks for Radiotherapy of Head and Neck Cancer—A Preliminary Study

A multi‐institutional retrospective study of carbon‐ion radiotherapy for non‐squamous cell malignant tumors of the nasopharynx: Subanalysis of Japan Carbon‐Ion Radiation Oncology Study Group study 1402 HN

Evaluation of mouthpiece fixation devices for head and neck radiotherapy patients fabricated in PolyJet photopolymer by a 3D printer

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