Adepitan A Owosho1, SaeHee K Yom2, Zhiqiang Han3, Kevin Sine3, Nancy Y Lee4, Joseph M Huryn5, Cherry L Estilo6. 1. Oral/Dental Oncology Research Fellow, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA. 2. Assistant Attending, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA. 3. Medical Dosimetrist, ProCure Proton Therapy Center, Somerset, NJ, USA. 4. Attending, Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, USA. 5. Chief, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA. 6. Attending, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA. Electronic address: Estiloc@mskcc.org.
Abstract
OBJECTIVE: The purpose of this study was to compare the dosimetric distribution of ipsilateral proton beam radiation therapy (PBRT) with intensity-modulated radiation therapy (IMRT) in the tooth-bearing region of the mandible in patients with head and neck cancer (HNC). STUDY DESIGN: The mandibular dosimetric distribution in patients with head and neck cancer treated with ≥60 Gy relative biologic equivalent PBRT was evaluated. The mean radiation doses were calculated in 5 regions: ipsilateral molar, ipsilateral premolar, anterior, contralateral premolar, and contralateral molar (CM) regions. CM was used as the reference region for comparative analysis. The mandibular dosimetric distribution in patients treated with PBRT was compared with that in IMRT patients with similar tumor sites and planning target volumes. RESULTS: The mean radiation dose to the contralateral regions was lower in patients treated with PBRT compared with those treated with IMRT. The average mean radiation doses to the reference region (CM) in patients treated with PBRT (relative biologic equivalent) versus IMRT were oropharynx (2.2 Gy vs 23.2 Gy; P < .00002), parotid (0 Gy vs 11.8 Gy; P = .01), and oral cavity (0.4 Gy vs 15.6 Gy; P = .006). CONCLUSIONS: This study revealed the effective tissue-sparing capability of PBRT compared with IMRT. Utilization of PBRT could translate to less radiation-related toxicity. Published by Elsevier Inc.
OBJECTIVE: The purpose of this study was to compare the dosimetric distribution of ipsilateral proton beam radiation therapy (PBRT) with intensity-modulated radiation therapy (IMRT) in the tooth-bearing region of the mandible in patients with head and neck cancer (HNC). STUDY DESIGN: The mandibular dosimetric distribution in patients with head and neck cancer treated with ≥60 Gy relative biologic equivalent PBRT was evaluated. The mean radiation doses were calculated in 5 regions: ipsilateral molar, ipsilateral premolar, anterior, contralateral premolar, and contralateral molar (CM) regions. CM was used as the reference region for comparative analysis. The mandibular dosimetric distribution in patients treated with PBRT was compared with that in IMRT patients with similar tumor sites and planning target volumes. RESULTS: The mean radiation dose to the contralateral regions was lower in patients treated with PBRT compared with those treated with IMRT. The average mean radiation doses to the reference region (CM) in patients treated with PBRT (relative biologic equivalent) versus IMRT were oropharynx (2.2 Gy vs 23.2 Gy; P < .00002), parotid (0 Gy vs 11.8 Gy; P = .01), and oral cavity (0.4 Gy vs 15.6 Gy; P = .006). CONCLUSIONS: This study revealed the effective tissue-sparing capability of PBRT compared with IMRT. Utilization of PBRT could translate to less radiation-related toxicity. Published by Elsevier Inc.
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