头颈癌的调强质子束放疗（IMPT）相较于基于光子的容积调强弧放疗（VMAT），可以为风险器官提供剂量上的好处。然而，对于牙齿区域的IMPT的潜在优势仅有有限数据。本研究旨在比较头颈癌患者的IMPT和VMAT放射剂量学的牙齿区域，以及识别预后因素来预测牙齿区域的累积照射剂量≥40Gy，该剂量被认为是预防性拔牙的阈值。该回顾性分析包括121位头颈癌患者的前瞻性收集的数据。我们比较了同一患者的多个牙齿区域IMPT和VMAT的平均Dmean值。对于收到牙齿承受区域累积放射剂量≥40Gy的VMAT和IMPT，我们进行了多元逻辑回归分析。应用IMPT于牙齿肿瘤区域后，Dmean值较低（p<0.001）。关于VMAT，口腔腔肿瘤、T3-T4肿瘤、下颌齿磨牙区域以及与肿瘤同侧的区域是牙齿区域接收累积照射剂量≥40Gy的危险因素。IMPT显著减少了牙齿区域的放射剂量。Copyright © 2023 The Authors. Published by Elsevier Ltd. All rights reserved.

Intensity modulated proton beam therapy (IMPT) for head and neck cancer offers dosimetric benefits for the organs at risk when compared to photon-based volumetric modulated arch therapy (VMAT). However, limited data exists about the potential benefits of IMPT for tooth-bearing regions. The aim of this study was to compare the IMPT and VMAT radiation dosimetrics of the tooth-bearing regions in head and neck cancer patients. Also, we aimed to identify prognostic factors for a cumulative radiation dose of ≥40 Gy on the tooth-bearing areas, which is considered the threshold dose for prophylactic dental extractions.A total of 121 head and neck cancer patients were included in this retrospective analysis of prospectively collected data. We compared the average Dmean values of IMPT versus VMAT of multiple tooth-bearing regions in the same patients. Multivariate logistic regression analysis was performed for receiving a cumulative radiation dose of ≥40 Gy to the tooth-bearing regions (primary endpoint) in both VMAT and IMPT.A lower Dmean was seen after applying IMPT to the tooth-bearing tumour regions (p < 0.001). Regarding VMAT, oral cavity tumours, T3-T4 tumours, molar regions in the mandible, and regions ipsilateral to the tumour were risk factors for receiving a cumulative radiation dose of ≥40 Gy.IMPT significantly reduces the radiation dose to the tooth-bearing regions.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.