The need for consensus on delineation and dose constraints of dento-facial structures in paediatric radiotherapy: results of a SIOPe survey

Abstract

<h3>Objectives</h3> Children receiving radiotherapy for head and neck tumours can experience severe late dento-facial effects. However, recommendations for delineation and dose assessment to dento-facial structures are lacking. We report on a survey aiming to better understand current practice and establish areas for development. <h3>Methods</h3> An online survey with nine questions was distributed to SIOPe members and paediatric radiotherapy centres in Australia and New Zealand with one response per department requested. Questions focused on current delineation practices and dose constraints used. <h3>Results</h3> After excluding 3 duplicates and 5 with missing department information, 52 complete responses from 27 countries were available (46 SIOPe, 5 Australia, 1 New Zealand). 29/52 respondents routinely delineate dento-facial structures, including the mandible (25 respondents), temporomandibular joint (TMJ) (22) and dentition (13) (Table 1). Others included the orbital (10), maxillary (8), sphenoid (3), nasal (2), ethmoid (1), composite (2) or other (5) bones. <h3>Conclusion</h3> In paediatric radiotherapy only few dento-facial structures are routinely delineated probably due to the absence of any contouring guidance. A contouring atlas and consensus recommendation on constraints can allow better guidance and understanding of late effects.