头颈部癌调强放射治疗中牙列区域的剂量分布：一项初步研究。
Dosimetric distribution to tooth-bearing areas in intensity-modulated radiation therapy for head and neck cancer: a pilot study.
作者信息
Bak Sun-Yung, Qi X Sharon, Kelly James A, Alexander Sherri, Chung Yunro, Gyurdzhyan Samvel, Patton Lauren L, Lee Steve P
机构信息
Clinical Assistant Professor, Department of Prosthodontics, University of North Carolina School of Dentistry, Chapel Hill, NC, USA.
Assistant Professor, Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA.
出版信息
Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Jan;121(1):43-8. doi: 10.1016/j.oooo.2015.10.007. Epub 2015 Oct 23.
OBJECTIVES
Dosimetric distribution of intensity-modulated radiotherapy (IMRT) to tooth-bearing areas for common head and neck (H&N) cancer sites were analyzed to facilitate minimization of osteoradionecrosis (ORN) risk through preradiation dental treatment planning.
STUDY DESIGN
Fifty-four patients received IMRT with prescribed doses ranging from 6000 centigrays (cGy) (adjuvant) to 6930 cGy (primary) to treat base of tongue (BOT), tonsil, larynx, nasopharynx, and hypopharynx cancers. The average maximal radiation dose delivered was recorded in tooth-bearing areas (anteriors, premolars, and first, second, and third molars) of the maxilla and mandible.
RESULTS
All tooth-bearing areas in laryngeal cancer cases received less than 2500 cGy. Maxillary and mandibular molar regions for BOT, tonsil, and hypopharynx cancers received 5000 cGy or higher. In nasopharynx cancers, maxillary teeth received higher doses than mandibular teeth.
CONCLUSIONS
Among 5 H&N subsites, mandibular molar regions for BOT, tonsil, and hypopharynx cancers received higher IMRT doses on average, posing the greatest ORN risk.
目的
分析调强放射治疗（IMRT）对常见头颈部（H&N）癌灶牙区的剂量分布，以便通过放疗前的牙科治疗计划将放射性骨坏死（ORN）风险降至最低。
研究设计
54例患者接受IMRT治疗，处方剂量范围为6000厘戈瑞（cGy）（辅助治疗）至6930 cGy（主要治疗），用于治疗舌根（BOT）、扁桃体、喉、鼻咽和下咽癌。记录上颌骨和下颌骨牙区（前牙、前磨牙以及第一、第二和第三磨牙）所接受的平均最大辐射剂量。
结果
喉癌病例的所有牙区所接受的辐射剂量均低于2500 cGy。BOT、扁桃体和下咽癌的上颌和下颌磨牙区接受的辐射剂量为5000 cGy或更高。在鼻咽癌中，上颌牙接受的剂量高于下颌牙。
结论
在5个H&N亚部位中，BOT、扁桃体和下咽癌的下颌磨牙区平均接受的IMRT剂量更高，ORN风险最大。
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