Literature DB >> 30090026

Pre-irradiation dental care: Ready-to-use templates for oropharyngeal cancers.

Raphaël Jumeau1, Phuc Félix Nguyen-Tan1, Houda Bahig1, Xavier Liem1, Louise Lambert1, Matthieu Schmittbuhl2, Dany Simard3, Edith Filion1.   

Abstract

AIM: To develop a tool in order to guide pre-irradiation dental care (PIDC) for patients with oropharyngeal cancers.
BACKGROUND: Osteoradionecrosis of the jaws is a potential complication of radiotherapy (RT) for head and neck cancers. To prevent this complication, PIDC can involve multiple dental extractions as a preventative measure to avoid post-RT complications. However, there is no standardized tool to guide PIDC.
MATERIALS AND METHODS: From January 2005 to October 2015, 120 head and neck cancer patients were prospectively included in a study investigating dysgeusia after RT. From this cohort, patients were enrolled according to the following inclusion criteria: histopathological confirmation of oropharyngeal squamous cell carcinoma; stage T1-4 N1-3 M0; ≤10 missing teeth. Individual teeth were retrospectively delineated on planning computed tomography and doses to dentition were assessed to generate templates.
RESULTS: Thirty-three patients were included. Molars received highest doses with a mean dose of 50 Gy (range; 19-75 Gy). Ipsi-lateral and contralateral wisdom teeth received RT dose superior to 50 Gy in 92% and 56% of cases, respectively. Patients with advanced disease (T4 or N2c-3) received higher mean doses on inferior and ipsi-lateral dental arches compared to other patients (T1-3 N0-2b): 42 Gy vs. 39 Gy and 44 Gy vs. 39 Gy (p < 0.05), respectively.
CONCLUSION: Pre-RT dose distribution templates are an objective way to prepare PIDC. Further studies with a larger cohort are needed to validate these templates.

Entities:  

Keywords:  Oral health; Oropharyngeal cancers; Osteoradionecrosis; Radiotherapy

Year:  2018        PMID: 30090026      PMCID: PMC6078107          DOI: 10.1016/j.rpor.2018.06.007

Source DB:  PubMed          Journal:  Rep Pract Oncol Radiother        ISSN: 1507-1367


  23 in total

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