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Comparative Dosimetric and Radiobiological Evaluation of Dental Structures and Normal Tissue Complication

Sunil Kumar Gulia¹, Jasmine Kalsi², Satish D Mehta³

¹Department of Oral and Maxillofacial Surgery, Shree Guru Gobind Singh Tricentenary University, Gurugram, IND.

|June 29, 2026

Summary

Advanced radiotherapy planning significantly improves head and neck cancer treatment by reducing radiation dose to dental structures and organs at risk. This leads to better tumor control and lower risks of xerostomia and osteoradionecrosis.

Keywords:

dental structures dose-volume histogram head and neck cancer normal tissue complication probability radiotherapy

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Area of Science:

Radiation Oncology
Medical Physics
Oncology

Background:

Head and neck cancers necessitate precise radiotherapy for optimal tumor control and critical structure sparing.
Advanced radiotherapy planning techniques are crucial for minimizing damage to surrounding tissues.

Purpose of the Study:

To compare advanced radiotherapy planning techniques for head and neck malignancies.
To evaluate the impact on dental structures, organs at risk (OAR), and radiobiological outcomes.

Main Methods:

Retrospective dosimetric study of 25 head and neck cancer patients.
Generation of two radiotherapy plans per patient using identical parameters.
Contouring of target volumes, OAR (including dental structures, parotid glands, mandible, spinal cord).
Analysis of dose-volume histogram parameters and normal tissue complication probability (NTCP) for xerostomia and osteoradionecrosis.

Main Results:

Arc-based delivery demonstrated superior plan quality with higher conformity and improved homogeneity.
Significant dose reduction to parotid glands, dental structures, and mandible.
Lower mean dose and volume receiving 30 gray for dental structures.
Reduced predicted probabilities for xerostomia and mandibular osteoradionecrosis.

Conclusions:

Advanced radiotherapy planning offers superior dose conformity and OAR sparing.
Significant reduction in predicted complications like xerostomia and osteoradionecrosis.
Supports clinical adoption for optimizing head and neck cancer treatment outcomes and patient quality of life.