Introduction: Nasopharyngeal carcinoma scarcely reported in children, while combined chemoradiotherapy is considered as the treatment of choice. However, the high radiation doses result in long-term affection of the hard and soft tissues, especially in young children that still present growth potential.
Aim: To present the long term defects after chemoradiotherapy, and to investigate whether the dose of radiation is constant throughout the oral cavity, thus equally affecting the corresponding dental and skeletal structures.
Methods: Panoramic and lateral cephalometric radiographs were used before and after treatment. Magnetic Resonance Imaging was also utilized. The delivered radiation dose on the dental and skeletal structures was evaluated for the large and the reduced parallel-opposed lateral field. The isodoses calculation was conducted by the 2D planning system for a 11x15 cm and a 7x15 cm, 1,25MV photon beam.
Results: Clinical and radiological findings six years after chemoradiotherapy based on a 2D computerized treatment planning system included radiation caries limited only to posterior teeth, proximal caries on anterior teeth, limited, but continual salivary flow, mild periodontal infection, mild xerostomia and a generative capacity of bones and he developmental process. The quantitative assessment of radiation delivered to the mandible revealed a high radiation dose in the posterior area and minimal in the anterior area. This may explain the differences in caries manifestation between anterior and posterior teeth.
Conclusions: According to the present study, individualized radiation fields, using 2D treatment planning system, result in restriction of severe damage of the dental and skeletal structures, which usually follows chemoradiotherapy.