Late Dental Toxicities After Proton Chemoradiation for Rhabdomyosarcoma: A Pediatric Case Report
Purpose: Radiation therapy is an independent risk factor for adverse sequelae to the oral cavity and dentition in childhood cancer survivors. However, dental toxicities after radiation therapy often are underreported and there are minimal published data on disturbances in tooth development after pro...
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| Format: | Article |
| Language: | English |
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Particle Therapy Co-operative Group
2022-11-01
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| Series: | International Journal of Particle Therapy |
| Subjects: | |
| Online Access: | https://theijpt.org/doi/pdf/10.14338/IJPT-22-00011.1 |
| _version_ | 1797939147783012352 |
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| author | Emma Foster-Thomas, BDS Marianne Aznar, PhD Daniel Indelicato, MD Shermaine Pan, FRCR Eunji Hwang,MBBS Peter Sitch, PhD Keith Horner, PhD Ed Smith,BM Simona Gaito, MD |
| author_facet | Emma Foster-Thomas, BDS Marianne Aznar, PhD Daniel Indelicato, MD Shermaine Pan, FRCR Eunji Hwang,MBBS Peter Sitch, PhD Keith Horner, PhD Ed Smith,BM Simona Gaito, MD |
| author_sort | Emma Foster-Thomas, BDS |
| collection | DOAJ |
| description | Purpose: Radiation therapy is an independent risk factor for adverse sequelae to the oral cavity and dentition in childhood cancer survivors. However, dental toxicities after radiation therapy often are underreported and there are minimal published data on disturbances in tooth development after proton beam therapy (PBT). We present the long-term clinical and radiographic dental findings 8 years after treatment completion for a patient treated with PBT and chemotherapy for rhabdomyosarcoma.
Materials and Methods: Clinical follow-up data of patients treated with PBT within the Proton Overseas Programme (POP) is stored in a National Database and curated by a dedicated outcomes unit at the Christie NHS PBT center. This case report was identified from the extraction and analysis of data for pediatric head and neck cancer patients in this database for a service evaluation project.
Results: The permanent dentition in this patient aged 3.5 years at the time of treatment was severely affected with abnormal dental development first observed 3.5 years after treatment completion. PBT delivered mean doses of 30 Gy(RBE = 1.1) to the maxilla and 25.9 Gy(RBE = 1.1) to the mandible.
Conclusion: Significant dental development abnormalities occurred in this pediatric patient, despite doses in areas being lower than the proposed thresholds in the literature. Improved descriptions of dental toxicities and routine contouring of the maxilla and mandible are needed to correlate dosimetric data. The dose to teeth should be kept as low as reasonably possible in younger patients until the dose thresholds for dental toxicities are known. |
| first_indexed | 2024-04-10T19:11:57Z |
| format | Article |
| id | doaj.art-354611aadc4444f7a33f9583860f2769 |
| institution | Directory Open Access Journal |
| issn | 2331-5180 |
| language | English |
| last_indexed | 2024-04-10T19:11:57Z |
| publishDate | 2022-11-01 |
| publisher | Particle Therapy Co-operative Group |
| record_format | Article |
| series | International Journal of Particle Therapy |
| spelling | doaj.art-354611aadc4444f7a33f9583860f27692023-01-30T13:05:15ZengParticle Therapy Co-operative GroupInternational Journal of Particle Therapy2331-51802022-11-01505710.14338/IJPT-22-00011.1i2331-5180-9-3-50Late Dental Toxicities After Proton Chemoradiation for Rhabdomyosarcoma: A Pediatric Case ReportEmma Foster-Thomas, BDS0Marianne Aznar, PhD1Daniel Indelicato, MD2Shermaine Pan, FRCR3Eunji Hwang,MBBS4Peter Sitch, PhD5Keith Horner, PhD6Ed Smith,BM7Simona Gaito, MD81 Restorative Dentistry, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, Manchester, UK2 Adaptive Radiotherapy, University of Manchester Division of Clinical Cancer Science, School of Medical Sciences, Manchester, UK3 Department of Radiation Oncology, University of Florida Health Proton Therapy Institute, Jacksonville, FL, USA4 Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK5 Department of Radiation Oncology, Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Australia6 Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK7 Dental and Maxillofacial Radiology, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, Manchester, UK4 Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK8 The Christie Proton Clinical Outcomes Unit/The University of Manchester Division of Clinical Cancer Science, School of Medical Sciences, Manchester, UKPurpose: Radiation therapy is an independent risk factor for adverse sequelae to the oral cavity and dentition in childhood cancer survivors. However, dental toxicities after radiation therapy often are underreported and there are minimal published data on disturbances in tooth development after proton beam therapy (PBT). We present the long-term clinical and radiographic dental findings 8 years after treatment completion for a patient treated with PBT and chemotherapy for rhabdomyosarcoma. Materials and Methods: Clinical follow-up data of patients treated with PBT within the Proton Overseas Programme (POP) is stored in a National Database and curated by a dedicated outcomes unit at the Christie NHS PBT center. This case report was identified from the extraction and analysis of data for pediatric head and neck cancer patients in this database for a service evaluation project. Results: The permanent dentition in this patient aged 3.5 years at the time of treatment was severely affected with abnormal dental development first observed 3.5 years after treatment completion. PBT delivered mean doses of 30 Gy(RBE = 1.1) to the maxilla and 25.9 Gy(RBE = 1.1) to the mandible. Conclusion: Significant dental development abnormalities occurred in this pediatric patient, despite doses in areas being lower than the proposed thresholds in the literature. Improved descriptions of dental toxicities and routine contouring of the maxilla and mandible are needed to correlate dosimetric data. The dose to teeth should be kept as low as reasonably possible in younger patients until the dose thresholds for dental toxicities are known.https://theijpt.org/doi/pdf/10.14338/IJPT-22-00011.1dental toxicitylate effectspediatrichead and neck cancerproton beam therapychemotherapy |
| spellingShingle | Emma Foster-Thomas, BDS Marianne Aznar, PhD Daniel Indelicato, MD Shermaine Pan, FRCR Eunji Hwang,MBBS Peter Sitch, PhD Keith Horner, PhD Ed Smith,BM Simona Gaito, MD Late Dental Toxicities After Proton Chemoradiation for Rhabdomyosarcoma: A Pediatric Case Report International Journal of Particle Therapy dental toxicity late effects pediatric head and neck cancer proton beam therapy chemotherapy |
| title | Late Dental Toxicities After Proton Chemoradiation for Rhabdomyosarcoma: A Pediatric Case Report |
| title_full | Late Dental Toxicities After Proton Chemoradiation for Rhabdomyosarcoma: A Pediatric Case Report |
| title_fullStr | Late Dental Toxicities After Proton Chemoradiation for Rhabdomyosarcoma: A Pediatric Case Report |
| title_full_unstemmed | Late Dental Toxicities After Proton Chemoradiation for Rhabdomyosarcoma: A Pediatric Case Report |
| title_short | Late Dental Toxicities After Proton Chemoradiation for Rhabdomyosarcoma: A Pediatric Case Report |
| title_sort | late dental toxicities after proton chemoradiation for rhabdomyosarcoma a pediatric case report |
| topic | dental toxicity late effects pediatric head and neck cancer proton beam therapy chemotherapy |
| url | https://theijpt.org/doi/pdf/10.14338/IJPT-22-00011.1 |
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