open access

Vol 23, No 4 (2018)
Original research articles
Published online: 2018-07-01
Submitted: 2018-01-31
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Pre-irradiation dental care: Ready-to-use templates for oropharyngeal cancers

Raphaël Jumeau, Phuc Félix Nguyen-Tan, Houda Bahig, Xavier Liem, Louise Lambert, Matthieu Schmittbuhl, Dany Simard, Edith Filion
DOI: 10.1016/j.rpor.2018.06.007
·
Rep Pract Oncol Radiother 2018;23(4):270-275.

open access

Vol 23, No 4 (2018)
Original research articles
Published online: 2018-07-01
Submitted: 2018-01-31

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.

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.

Get Citation

Keywords

Oropharyngeal cancers; Radiotherapy; Oral health; Osteoradionecrosis

About this article
Title

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

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 23, No 4 (2018)

Pages

270-275

Published online

2018-07-01

DOI

10.1016/j.rpor.2018.06.007

Bibliographic record

Rep Pract Oncol Radiother 2018;23(4):270-275.

Keywords

Oropharyngeal cancers
Radiotherapy
Oral health
Osteoradionecrosis

Authors

Raphaël Jumeau
Phuc Félix Nguyen-Tan
Houda Bahig
Xavier Liem
Louise Lambert
Matthieu Schmittbuhl
Dany Simard
Edith Filion

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