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. 2012 Jan 1;82(1):355-60.
doi: 10.1016/j.ijrobp.2010.09.031. Epub 2010 Nov 17.

Jaw dysfunction related to pterygoid and masseter muscle dosimetry after radiation therapy in children and young adults with head-and-neck sarcomas

Matthew J Krasin  1 , Kristin M Wiese, Sheri L Spunt, Chia-Ho Hua, Najat Daw, Fariba Navid, Andrew M Davidoff, Lisa McGregor, Thomas E Merchant, Larry E Kun, Lola McCrarey, Kelly A Hoth, Xiaowei Yan, Xiaoping Xiong
Affiliations

Jaw dysfunction related to pterygoid and masseter muscle dosimetry after radiation therapy in children and young adults with head-and-neck sarcomas

Matthew J Krasin et al. Int J Radiat Oncol Biol Phys. .

Abstract

Purpose: 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 and materials: 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.

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Figures

Figure 1
Figure 1
Example of masseter and pterygoid contours overlaid with radiation dosimetry on a coregistered MR.
Figure 2
Figure 2
Example of a jaw depression measurement being obtained (measured between the incisors).
Figure 3
Figure 3
Cumulative dose-volume histograms for all patients' mandibular muscles.
See this image and copyright information in PMC

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