Utility of intraoral stents in external beam radiotherapy for head and neck cancer

Doi, Hiroshi; Tanooka, Masao; Ishida, Tatsuhiro; Moridera, Kuniyasu; Ichimiya, Kenji; Tarutani, K.; Kitajima, Kazuhiro; Fujiwara, Masayuki; Kishimoto, Hiroyuki; Kamikonya, Norihiko

doi:10.1016/j.rpor.2017.03.002

Cited by 34 publications

(32 citation statements)

References 30 publications

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“…Mouthpieces are widely used for occlusal fixation and tongue retraction in head and neck radiotherapy, and their usefulness has been widely reported [1][2][3][4][5]. Furthermore, the effectiveness of a newly developed water-equivalent mouthpiece during external beam radiotherapy for oral cancer has been described [4].…”

Section: Introductionmentioning

confidence: 99%

“…In external beam radiotherapy for cancer in the tongue, floor of the mouth, and lower gingiva, mouthpieces can reduce the radiation dose to the upper gingiva or hard palate by keeping the mouth open [2,3]. Mouthpieces can also immobilize the tongue, which is important when treating patients with tongue cancer using external beam radiotherapy [4,5]. Additionally, mouthpieces can reportedly reduce the radiation dose to healthy structures such as the bone tissue and the salivary glands [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Mouthpieces can also immobilize the tongue, which is important when treating patients with tongue cancer using external beam radiotherapy [4,5]. Additionally, mouthpieces can reportedly reduce the radiation dose to healthy structures such as the bone tissue and the salivary glands [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Currently, we use mouthpieces for head and neck radiotherapy using a type of Exafine putty manufactured by the GC Co., Tokyo, Japan (GCEP) [17], which is dental impression material, for the purposes of occlusion fixation at mouth-opening position and tongue immobilization. Making mouthpieces with dental material is costly in terms of the time and labor required to obtain an impression of the patient, make the gypsum model, and make the mouthpiece using resin [2][3][4][5]. GCEP mouthpieces are advantageous because they can be created directly within minutes.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of mouthpiece fixation devices for head and neck radiotherapy patients fabricated in PolyJet photopolymer by a 3D printer

et al. 2019

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The purpose of our study was to evaluate the usefulness of a biocompatible class VI resin PolyJet photopolymer Objet MED610 (MED610)-made mouthpiece fabricated using a 3D printer as a fixation device for head and neck radiotherapy patients. Methods: Five mouthpieces made of GC Exafine putty type (GCEP) were fabricated from five dry skull bones. After computed tomography reconstruction of the GCEP-made mouthpiece and its surface extraction, the MED610-made mouthpieces were replicated. The sizes of the GCEP and MED610 mouthpieces were measured with a vernier caliper in width, length, and height, respectively. The volumes of these mouthpieces were measured by Archimedes' principle using pure water. For dose evaluation, the GCEP and MED610 mouthpieces were placed in the same part of a water phantom, and a 4-MV X-ray beam was located at the left maxillary gingiva, buccal mucosa, and oral floor. The dose for the planning target volume (PTV) was evaluated. Results: The differences in the mean size and volume between the GCEP and MED610 mouthpieces were 0.03 mm and 0.21 cm 3 , respectively. Compared with the conventional GCEP mouthpiece, the dose absorption in the MED610 mouthpiece was closer to that in only water. When the mouthpiece was within the PTV margin, the minimum coverage dose at 95% of the PTV increased by 2.4% in the maxillary gingiva and by 3.6% in the buccal mucosa. Conclusion: A 3D printer can construct a mouthpiece accurately. The MED610 mouthpiece is suitable for use in dosimetry in head and neck radiotherapy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of mouthpiece fixation devices for head and neck radiotherapy patients fabricated in PolyJet photopolymer by a 3D printer

et al. 2019

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“…Using CBCT obtained from the on-board imager (OBI), the patient's contour can be delineated and its shape and extent changes can be determined using deformable image registration (DIR) from original planning (9)(10)(11). For head and neck cancer patients, weight loss and setup accuracy are important, as these influence the dose distribution during IMRT (12)(13)(14). Furthermore, setup errors in the neck region of patients are generally greater compared to those occurring in the head region during the course of radiotherapy (15).…”

mentioning

confidence: 99%

Variations of the Dose Distribution Between CT- and CBCT-based Plans for Oropharyngeal Cancer

Otsuka

Monzen

Ishikawa

et al. 2019

In Vivo

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Background/Aim: The parotid glands in the head and neck are organs at risks (OARs) adjacent to high dose region and dose of OARs might be increased during the course of radiotherapy. The influence factors of the dose distribution for the parotid glands were investigated in terms of weight loss and mandibular rotation for head and neck cancers treated with volumetric modulated arc therapy (VMAT). Patients and Methods: Ten oropharyngeal cancer patients (OPC) who underwent VMAT were enrolled. The dose volume histogram (DVH) parameters of the parotid glands and planning target volume (PTV) were compared between the planning computed tomography (CT) and the on board imager (OBI) at 1, 5, 10, 15, and 20 fractions. Results: The variation of dose distribution in PTV was not observed in both factors. The relationship between the mandibular rotation and dose difference for the right and left parotid glands (linear regression, r 2 =0.1577 and −0.689) showed a slighty stronger correlation with dose difference than the weight loss (linear regression, r 2 =−0.079 and −0.547). Conclusion: The mandibular rotation tends to have a large influence on dose distribution of the parotid glands for head and neck cancers treated with VMAT.

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Benefits of intraoral stents in patients with head and neck cancer undergoing radiotherapy: Systematic review

et al. 2021

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Intraoral stents aim to reduce the oral complications associated with head and neck cancers radiotherapy. The aim of this study is to determine the benefits associated with these devices. A systematic review was conducted in PubMed, Web of Science, and Scopus databases selecting full articles published in English, Portuguese, or Spanish until June 6, 2020 (PROSPERO registration: CRD42020185065). The studies were evaluated by Hadorn and Somerfield criteria and guidelines were established. Nineteen studies were identified suggesting the use of intraoral stent for radiotherapy for patients with cancer on/near the mandible to reduce oral mucositis, trismus, xerostomia (LoE III), and dose in healthy structures (LoE IV) and for cancer on/near the maxilla to reduce oral mucositis and dose in healthy structures (LoE IV). Despite the limited scientific evidence, several benefits associated with the use of intraoral stent for radiotherapy of the head and neck neoplasia have been reported.

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Utility of intraoral stents in external beam radiotherapy for head and neck cancer

Abstract: Setup errors can be significantly reduced in the AP and 3D-directions by using intraoral stents.

Cited by 34 publications

References 30 publications

Evaluation of mouthpiece fixation devices for head and neck radiotherapy patients fabricated in PolyJet photopolymer by a 3D printer

Evaluation of mouthpiece fixation devices for head and neck radiotherapy patients fabricated in PolyJet photopolymer by a 3D printer

Variations of the Dose Distribution Between CT- and CBCT-based Plans for Oropharyngeal Cancer

Benefits of intraoral stents in patients with head and neck cancer undergoing radiotherapy: Systematic review

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