Dosimetric distribution to the tooth-bearing regions of the mandible following intensity-modulated radiation therapy for base of tongue cancer

Hansen, Heidi; Maritim, Beatrice C.; Bohle, George C.; Lee, Nancy Y.; Huryn, Joseph M.; Estilo, Cherry L.

doi:10.1016/j.oooo.2012.01.024

Cited by 49 publications

(48 citation statements)

References 16 publications

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“…This finding is in accordance to Bak et al [26] that using IMRT obtained higher doses of radiation in molars of patients affected by cancers from the base of the tongue, tonsil and hypopharynx. Similarly, Hansen et al [27] and Parahyba et al [20] also obtained higher radiation values for molars, reporting that tumor size is very important to predict the amount of radiation delivered to tooth-bearing regions, since large tumors revealed high doses in the entire mandible, for this reason we attempted to gather tumors with as much similar TNM stage as possible.…”

Section: Discussionmentioning

confidence: 90%

IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients

et al. 2016

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BackgroundRadiotherapy (RT) is frequently used in the treatment of head and neck cancer, but different side-effects are frequently reported, including a higher frequency of radiation-related caries, what may be consequence of direct radiation to dental tissue. The intensity-modulated radiotherapy (IMRT) was developed to improve tumor control and decrease patient’s morbidity by delivering radiation beams only to tumor shapes and sparing normal tissue. However, teeth are usually not included in IMRT plannings and the real efficacy of IMRT in the dental context has not been addressed. Therefore, the aim of this study is to assess whether IMRT delivers lower radiation doses to dental structures than conformal 3D radiotherapy (3DRT).Material and methodsRadiation dose delivery to dental structures of 80 patients treated for head and neck cancers (oral cavity, tongue, nasopharynx and oropharynx) with IMRT (40 patients) and 3DRT (40 patients) were assessed by individually contouring tooth crowns on patients’ treatment plans. Clinicopathological data were retrieved from patients’ medical files.ResultsThe average dose of radiation to teeth delivered by IMRT was significantly lower than with 3DRT (p = 0.007); however, only patients affected by nasopharynx and oral cavity cancers demonstrated significantly lower doses with IMRT (p = 0.012 and p = 0.011, respectively). Molars received more radiation with both 3DRT and IMRT, but the latter delivered significantly lower radiation in this group of teeth (p < 0.001), whereas no significant difference was found for the other dental groups. Maxillary teeth received lower doses than mandibular teeth, but only IMRT delivered significantly lower doses (p = 0.011 and p = 0.003). Ipsilateral teeth received higher doses than contralateral teeth with both techniques and IMRT delivered significantly lower radiation than 3DRT for contralateral dental structures (p < 0.001).ConclusionIMRT delivered lower radiation doses to teeth than 3DRT, but only for some groups of patients and teeth, suggesting that this decrease was more likely due to the protection of other high risk organs, and was not enough to remove teeth from the zone of high risk for radiogenic disturbance (>30Gy).

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Section: Discussionmentioning

confidence: 90%

IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients

et al. 2016

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“…It has been shown that IMRT results in less xerostomia due to sparing of the parotid and/or submandibular glands [43]. But at the same time, sparing of glands may result in higher doses to the other tissues in the radiation field, such as the jawbone [44]. These potentially higher doses to the jawbone increase the risk of developing ORN.…”

Section: Periodontitismentioning

confidence: 99%

Evidence supporting pre-radiation elimination of oral foci of infection in head and neck cancer patients to prevent oral sequelae. A systematic review

et al. 2015

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“…1 Thus, major salivary glands and teeth often receive high doses of radiation and collectively cause postradiation damage to the dentition mediated by hyposalivation and a possible direct radiogenic enamel and dentin destruction, with an apparent additive impact as total doses to teeth increase. 2 The present study confirmed recent evidence 2 that teeth are often exposed to cumulative radiation doses that can be as high as the final radiation dose delivered to the gross tumor volumes during HNR.…”

mentioning

confidence: 99%

Dosimetric distribution to the teeth of patients with head and neck cancer who underwent radiotherapy

Morais-Faria

Menegussi

Vasconcelos

et al. 2015

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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Dosimetric distribution to the tooth-bearing regions of the mandible following intensity-modulated radiation therapy for base of tongue cancer

Cited by 49 publications

References 16 publications

IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients

IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients

Evidence supporting pre-radiation elimination of oral foci of infection in head and neck cancer patients to prevent oral sequelae. A systematic review

Dosimetric distribution to the teeth of patients with head and neck cancer who underwent radiotherapy

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