IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | https://doi.org/10.1186/s13014-016-0694-7 http://hdl.handle.net/1843/57551 https://orcid.org/0000-0001-5196-7631 https://orcid.org/0000-0001-9128-3138 https://orcid.org/0000-0002-4835-9624 https://orcid.org/0000-0002-6657-4547 https://orcid.org/0000-0001-9544-6555 https://orcid.org/0000-0002-8410-4303 https://orcid.org/0000-0003-2040-6617 |
Resumo: | Background Radiotherapy (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 methods Radiation 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. Results The 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). Conclusion IMRT 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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2023-08-07T18:17:08Z2023-08-07T18:17:08Z20161111619https://doi.org/10.1186/s13014-016-0694-71748-717Xhttp://hdl.handle.net/1843/57551https://orcid.org/0000-0001-5196-7631https://orcid.org/0000-0001-9128-3138https://orcid.org/0000-0002-4835-9624https://orcid.org/0000-0002-6657-4547https://orcid.org/0000-0001-9544-6555https://orcid.org/0000-0002-8410-4303https://orcid.org/0000-0003-2040-6617Background Radiotherapy (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 methods Radiation 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. Results The 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). Conclusion IMRT 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).porUniversidade Federal de Minas GeraisUFMGBrasilFAO - DEPARTAMENTO DE ODONTOLOGIA SOCIAL E PREVENTIVARadiation OncologyRadioterapiaDentesCabeça - CâncerPescoço - CâncerIntensity-modulated radiotherapy3D radiotherapyHead and neck cancerTeethDental structuresIMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patientsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://ro-journal.biomedcentral.com/articles/10.1186/s13014-016-0694-7#:~:text=Conclusion,radiogenic%20disturbance%20(%3E30Gy).Eduardo Rodrigues FregnaniThais Bianca BrandãoCláudia Joffily ParahybaKarina Morais FariaFelipe Paiva FonsecaPedro Augusto Mendes RamosFábio Yone de MoraesKarina Gondim Moutinho da Conceição VasconcelosGisela MenegussiAlan Roger dos Santos Silvainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/57551/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALIMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients.pdfIMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients.pdfapplication/pdf3084083https://repositorio.ufmg.br/bitstream/1843/57551/2/IMRT%20delivers%20lower%20radiation%20doses%20to%20dental%20structures%20than%203DRT%20in%20head%20and%20neck%20cancer%20patients.pdfb18ea63d1b166168b72b2c4f8ceb0bc0MD521843/575512023-08-07 15:17:08.966oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-08-07T18:17:08Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients |
title |
IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients |
spellingShingle |
IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients Eduardo Rodrigues Fregnani Intensity-modulated radiotherapy 3D radiotherapy Head and neck cancer Teeth Dental structures Radioterapia Dentes Cabeça - Câncer Pescoço - Câncer |
title_short |
IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients |
title_full |
IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients |
title_fullStr |
IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients |
title_full_unstemmed |
IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients |
title_sort |
IMRT delivers lower radiation doses to dental structures than 3DRT in head and neck cancer patients |
author |
Eduardo Rodrigues Fregnani |
author_facet |
Eduardo Rodrigues Fregnani Thais Bianca Brandão Cláudia Joffily Parahyba Karina Morais Faria Felipe Paiva Fonseca Pedro Augusto Mendes Ramos Fábio Yone de Moraes Karina Gondim Moutinho da Conceição Vasconcelos Gisela Menegussi Alan Roger dos Santos Silva |
author_role |
author |
author2 |
Thais Bianca Brandão Cláudia Joffily Parahyba Karina Morais Faria Felipe Paiva Fonseca Pedro Augusto Mendes Ramos Fábio Yone de Moraes Karina Gondim Moutinho da Conceição Vasconcelos Gisela Menegussi Alan Roger dos Santos Silva |
author2_role |
author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Eduardo Rodrigues Fregnani Thais Bianca Brandão Cláudia Joffily Parahyba Karina Morais Faria Felipe Paiva Fonseca Pedro Augusto Mendes Ramos Fábio Yone de Moraes Karina Gondim Moutinho da Conceição Vasconcelos Gisela Menegussi Alan Roger dos Santos Silva |
dc.subject.por.fl_str_mv |
Intensity-modulated radiotherapy 3D radiotherapy Head and neck cancer Teeth Dental structures |
topic |
Intensity-modulated radiotherapy 3D radiotherapy Head and neck cancer Teeth Dental structures Radioterapia Dentes Cabeça - Câncer Pescoço - Câncer |
dc.subject.other.pt_BR.fl_str_mv |
Radioterapia Dentes Cabeça - Câncer Pescoço - Câncer |
description |
Background Radiotherapy (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 methods Radiation 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. Results The 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). Conclusion IMRT 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). |
publishDate |
2016 |
dc.date.issued.fl_str_mv |
2016 |
dc.date.accessioned.fl_str_mv |
2023-08-07T18:17:08Z |
dc.date.available.fl_str_mv |
2023-08-07T18:17:08Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1843/57551 |
dc.identifier.doi.pt_BR.fl_str_mv |
https://doi.org/10.1186/s13014-016-0694-7 |
dc.identifier.issn.pt_BR.fl_str_mv |
1748-717X |
dc.identifier.orcid.pt_BR.fl_str_mv |
https://orcid.org/0000-0001-5196-7631 https://orcid.org/0000-0001-9128-3138 https://orcid.org/0000-0002-4835-9624 https://orcid.org/0000-0002-6657-4547 https://orcid.org/0000-0001-9544-6555 https://orcid.org/0000-0002-8410-4303 https://orcid.org/0000-0003-2040-6617 |
url |
https://doi.org/10.1186/s13014-016-0694-7 http://hdl.handle.net/1843/57551 https://orcid.org/0000-0001-5196-7631 https://orcid.org/0000-0001-9128-3138 https://orcid.org/0000-0002-4835-9624 https://orcid.org/0000-0002-6657-4547 https://orcid.org/0000-0001-9544-6555 https://orcid.org/0000-0002-8410-4303 https://orcid.org/0000-0003-2040-6617 |
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1748-717X |
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por |
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por |
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Radiation Oncology |
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openAccess |
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Universidade Federal de Minas Gerais |
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UFMG |
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Brasil |
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FAO - DEPARTAMENTO DE ODONTOLOGIA SOCIAL E PREVENTIVA |
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Universidade Federal de Minas Gerais |
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