Effects of therapy on dentofacial development in long-term survivors of head and neck rhabdomyosarcoma: the memorial sloan-kettering cancer center experience.
OBJECTIVE
To describe potential effects of multimodality therapy on dental and facial development in long-term survivors of head and neck rhabdomyosarcoma.


METHODS
The medical records of all patients aged 20 years or less presenting between 1985 and 1996 with a diagnosis of rhabdomyosarcoma and treated by protocol were reviewed. Head and neck rhabdomyosarcoma patients who were followed in the Dental Service and were alive and free of disease with at least a 5-year follow-up were included in the review. Ten patients satisfied the inclusion criteria and form the basis of this report. The median age at diagnosis of the 10 patients was 4.3 years (range 10 months to 19.5 years). All patients were treated with chemotherapy, two patients underwent surgery, and all but one patient received external beam radiation therapy.


RESULTS
Clinical or radiographic dentofacial abnormalities were observed in 8 of the 10 (80%) patients. Abnormalities included enamel defects, bony hypoplasia/facial asymmetry, trismus, velopharyngeal incompetency, tooth/root agenesis, and disturbance in root development. Bony hypoplasia and disturbance in root formation were the most common findings.


CONCLUSIONS
Multimodality therapy for head and neck rhabdomyosarcoma can result in dentofacial abnormalities that affect the patient's quality of life. The care of the long-term survivor requires a multidisciplinary approach, including early involvement of the dental team.
Estilo
Cherry L
CL
Dental Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. estiloc@mskcc.org
Huryn
Joseph M
JM
Kraus
Dennis H
DH
Sklar
Charles A
CA
Wexler
Leonard H
LH
Wolden
Suzanne L
SL
Zlotolow
Ian M
IM
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D008445:Maxillofacial Development / Q000187:drug effects* / Q000528:radiation effects*; D011878:Radiotherapy / Q000009:adverse effects*; D012208:Rhabdomyosarcoma / Q000628:therapy*; D017741:Survivors; D014070:Tooth / Q000187:drug effects / Q000528:radiation effects; D014076:Tooth Diseases / Q000209:etiology*
D000970:Antineoplastic Agents