title: Dosimetric distribution to tooth-bearing areas in intensity-modulated radiation therapy for head and neck cancer: a pilot study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Clinical Assistant Professor, Department of Prosthodontics, University of North Carolina School of Dentistry, Chapel Hill, NC, USA. Electronic address: Sybakdds@email.unc.edu.
authors.forename: Sun-Yung
authors.initials: SY
authors.lastname: Bak
authors.affiliation: Assistant Professor, Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: X Sharon
authors.initials: XS
authors.lastname: Qi
authors.affiliation: Assistant Professor, Mayo Clinic College of Medicine, Mayo Clinic; Consultant, Division of Prosthetic and Esthetic Dentistry, Department of Dental Specialties, Mayo Clinic, Rochester, MN, USA.
authors.forename: James A
authors.initials: JA
authors.lastname: Kelly
authors.affiliation: Dosimetrist, Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Sherri
authors.initials: S
authors.lastname: Alexander
authors.affiliation: Department of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA.
authors.forename: Yunro
authors.initials: Y
authors.lastname: Chung
authors.affiliation: Quality Assurance Research Technician, Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Samvel
authors.initials: S
authors.lastname: Gyurdzhyan
authors.affiliation: Professor and Chair, Department of Dental Ecology, University of North Carolina School of Dentistry, Chapel Hill, NC, USA.
authors.forename: Lauren L
authors.initials: LL
authors.lastname: Patton
authors.affiliation: Professor, Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Steve P
authors.initials: SP
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008334:Mandible / Q000528:radiation effects*; D008437:Maxilla / Q000528:radiation effects*; D008875:Middle Aged; D010025:Osteoradionecrosis / Q000209:etiology*; D010865:Pilot Projects; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D012307:Risk Factors; D014070:Tooth / Q000528:radiation effects*