Raghava Preethi, G (2020) Sparing of Dental Structures in Head and Neck Cancers treated with Intensity Modulated Radiation Therapy: The Dosimetric Evaluation and Functional Outcomes in Comparison with 3D Conformal Therapy. Masters thesis, Cancer Institute (W. I. A.), Chennai.
|
Text
200903920raghava_preethi.pdf Download (4MB) | Preview |
Abstract
INTRODUCTION: Head and neck cancers are one of the most common cancers in India and in increasing trend and are aggressive. Multiple treatment-associated side effects are also encountered. With new treatment techniques such as IMRT, aim of improving the functional outcome and quality of life in head and neck cancers in addition to improving prognosis and overall survival rates are achieved by significant reduction in the side-effects by sparing normal tissues to a good extent and delivering larger doses to tumor more accurately. The real efficacy of IMRT in sparing normal dental structures has not been addressed fully and dosimetric data comparison with conformal technique and its correlation with acute dental outcomes have to be analysed. MATERIAL AND METHODS: A total of 30 patients, histologically proven head and neck cancers planned for definitive radiation/chemoradiation are prospectively allocated in two groups and IMRT plans and conformal 3D plans are generated. The dental structures like anterior tooth area including incisors and canines, premolar and molar tooth area in maxilla and mandible both sides (ipsilateral and contralateral sides) in reference to tumor location are marked and contoured using CT images on planning software. The average mean and maximum volumetric dose histiograms are generated. The sitewise dose distribution are evaluated and compared in both groups. Patients had complete dental examination prior to, during and after treatment at regular intervals. DISCUSSION: On analysis, mean dose and maximum dose delivered to tooth bearing areas are significantly lower in IMRT technique. Average mean and maximum dose delivered are 3900 cGy and 6300 cGy in conformal whereas 2600 cGy and 5400cGy in IMRT technique. Most of the patients developed acute mucositis/gingivitis during treatment and subacute complication is xerostomia. Dental complications encountered are dental caries, loosened teeth and most commonly hypersensitivity. Patients treated with IMRT technique particularly in patients who has received low mean doses to dental structures found to lesser incidence of these morbidity of dental structures and better functional quality than conformal technique.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 201719102 |
| Uncontrolled Keywords: | IMRT, Conformal, Mean Dose, Dental Structures, Treatment Morbidity, Dose Volumetric histogram, Dosimetric evaluation. |
| Subjects: | MEDICAL > Radio Therapy |
| Depositing User: | Subramani R |
| Date Deposited: | 01 Feb 2021 05:01 |
| Last Modified: | 01 Feb 2021 05:01 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13642 |
Actions (login required)
 |
View Item |
