Feng Z, Wang P, Gong L, Xu L, Zhang J, Zheng J, Zhang D, Tian T, Wang P
Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, 300060 Tianjin, China; Department of Radiation Oncology, Tianjin Chest Hospital, 300350 Tianjin, China.
Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, 300060 Tianjin, China.
Cancer Radiother. 2019 Apr;23(2):125-131. doi: 10.1016/j.canrad.2018.05.005. Epub 2019 Mar 18.
In the present study we constructed a new customized bite block and evaluated its effect on dosimetric and clinical features in radiotherapy.
The key point of this method is using the oral stent and silicon rubber through a procedure of making fine intraoral impressions. For type I customized bite block, only the upper and lower alveoli of the oral stent are coated with silicone rubber and impressions of the teeth can be obtained. For type II customized bite block, all parts of the oral stent are coated with silicone rubber to make sure impressions of the teeth, tongue and other intraoral tissues can be obtained. Sixty patients undergoing radiotherapy of nasal cavity, paranasal sinuses and oromaxillofacial area were evaluated. For each patient, intensity-modulated radiotherapy plans created with and without customized bite block were compared and data were collected on radiation-induced complications.
The total fabricating time was approximately 20minutes, and the cost was approximately 10 US dollars. Type I customized bite block is applicable to cancer of sinuses and nasal cavity. Type II customized bite block is applicable to cancer of the oral cavity, salivary glands, especially tongue cancer. The use of the customized bite block showed promising results in decreasing the radiation dose to organs at risk during intensity-modulated radiotherapy. No patients had oral mucositis (grade 3 or above), taste dysfunction, or xerostomia during and post radiotherapy.
A customized bite block is easy-made and worthy of clinical use.
在本研究中，我们制作了一种新型定制咬块，并评估其在放射治疗中对剂量学和临床特征的影响。
该方法的关键在于通过精细的口腔印模制作过程使用口腔支架和硅橡胶。对于I型定制咬块，仅在口腔支架的上下牙槽涂上硅橡胶，即可获得牙齿印模。对于II型定制咬块，口腔支架的所有部分都涂上硅橡胶，以确保获得牙齿、舌头和其他口腔组织的印模。对60例接受鼻腔、鼻窦和口腔颌面部放射治疗的患者进行了评估。对每位患者，比较了使用定制咬块和未使用定制咬块创建的调强放射治疗计划，并收集了放射性并发症的数据。
总制作时间约为20分钟，成本约为10美元。I型定制咬块适用于鼻窦和鼻腔癌。II型定制咬块适用于口腔癌、唾液腺癌，尤其是舌癌。在调强放射治疗期间，使用定制咬块在降低危及器官的辐射剂量方面显示出有前景的结果。放疗期间及放疗后，无患者出现口腔黏膜炎（3级或以上）、味觉功能障碍或口干。
定制咬块制作简便，值得临床应用。
