title: Jaw dysfunction related to pterygoid and masseter muscle dosimetry after radiation therapy in children and young adults with head-and-neck sarcomas.
abstract: OBJECTIVE
  To investigate the relationship between jaw function, patient and treatment variables, and radiation dosimetry of the mandibular muscles and joints in children and young adults receiving radiation for soft-tissue and bone sarcomas.
  
  
  METHODS
  Twenty-four pediatric and young adult patients with head-and-neck sarcomas were treated on an institutional review board-approved prospective study of focal radiation therapy for local tumor control. Serial jaw depression measurements were related to radiation dosimetry delivered to the medial and lateral pterygoid muscles, masseter muscles, and temporomandibular joints to generate mathematical models of jaw function.
  
  
  RESULTS
  Baseline jaw depression was only influenced by the degree of surgical resection. In the first 12 weeks from initiation of radiation, surgical procedures greater than a biopsy, administration of cyclophosphamide containing chemotherapy regimes, and large gross tumor volumes adversely affected jaw depression. Increasing dose to the pterygoid and masseter muscles above 40 Gy predicted loss of jaw function over the full course of follow-up.
  
  
  CONCLUSIONS
  Clinical and treatment factors are related to initial and subsequent jaw dysfunction. Understanding these complex interactions and the affect of specific radiation doses may help reduce the risk for jaw dysfunction in future children and young adults undergoing radiation therapy for the management of soft-tissue and bone sarcomas.
authors.affiliation: Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, TN 38105, USA. matthew.krasin@stjude.org
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Krasin
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Wiese
authors.forename: Sheri L
authors.initials: SL
authors.lastname: Spunt
authors.forename: Chia-Ho
authors.initials: CH
authors.lastname: Hua
authors.forename: Najat
authors.initials: N
authors.lastname: Daw
authors.forename: Fariba
authors.initials: F
authors.lastname: Navid
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Davidoff
authors.forename: Lisa
authors.initials: L
authors.lastname: McGregor
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Merchant
authors.forename: Larry E
authors.initials: LE
authors.lastname: Kun
authors.forename: Lola
authors.initials: L
authors.lastname: McCrarey
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Hoth
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Yan
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Xiong
mesh_terms: D000293:Adolescent; D001859:Bone Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002817:Chordoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D007223:Infant; D007571:Jaw Diseases / Q000209:etiology* / Q000503:physiopathology; D008406:Masseter Muscle / Q000503:physiopathology / Q000528:radiation effects*; D008954:Models, Biological; D012516:Osteosarcoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D011446:Prospective Studies; D011626:Pterygoid Muscles / Q000503:physiopathology / Q000528:radiation effects*; D011832:Radiation Injuries / Q000150:complications; D011879:Radiotherapy Dosage; D012208:Rhabdomyosarcoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D012509:Sarcoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D012512:Sarcoma, Ewing / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D013704:Temporomandibular Joint / Q000503:physiopathology / Q000528:radiation effects*; D047368:Tumor Burden; D055815:Young Adult