Late dental and bone alterations in patients after orbital rhabdomyosarcoma treatment

• Published in: Supportive care in cancer 2024-10, Vol.32 (10), p.642, Article 642
• Main Authors: de Mattos, Valkiria D. Aiuto, Ferman, Sima Esther, Magalhães, Denise Maria Araújo, da Costa, Felipe Vieira, Antunes, Héliton Spíndola, Junior, Arley Silva
• Format: Article
• Language: English
• Subjects: Adolescent; Antineoplastic Combined Chemotherapy Protocols; Bones; Cancer Survivors - statistics & numerical data; Chemoradiotherapy - adverse effects; Chemoradiotherapy - methods; Chemotherapy; Child; Child, Preschool; Cross-Sectional Studies; Cyclophosphamide - administration & dosage; Eye cancer; Female; Humans; Infant; Male; Medicine; Medicine & Public Health; Nursing; Nursing Research; Oncology; Orbital Neoplasms - therapy; Pain Medicine; Pediatrics; Radiation therapy; Rehabilitation Medicine; Rhabdomyosarcoma; Rhabdomyosarcoma - therapy; Side effects; Teenagers; Teeth; Vincristine - administration & dosage; Young Adult; Young adults
• ISSN: 0941-4355; 1433-7339; 1433-7339
• DOI: 10.1007/s00520-024-08843-2

Purpose Orbital rhabdomyosarcoma is a rare soft tissue sarcoma in childhood but with a good prognosis. Treatment usually includes surgery, chemotherapy, and radiotherapy. This study aimed to evaluate long-term alterations in teeth and cranial bones in children, adolescents, and young adults after oncologic treatment for childhood orbital rhabdomyosarcoma. Method This was a cross-sectional study that evaluated patients treated for orbital rhabdomyosarcoma between 1988 and 2011. Demographic, clinical, and treatment data were collected during the study period; also, panoramic radiographs, cephalometric study, and photographs of the face were taken. Results Eight long-term survivors were studied. Of those, 50% were male, 75% had less than 5 years of treatment, and 88% had only one of the orbits affected by the tumor. Regarding treatment, 50% received 50.4 Gy of radiotherapy in the orbit; the chemotherapy included vincristine, actinomycin D, and cyclophosphamide in 75% of the cases and also ifosfamide and etoposide in 25%. The children presented craniofacial alterations, mainly when radiotherapy occurred between 0 and 5 years old ( p  = 0.01). The mandibles also showed dental alterations, probably due to chemotherapy. Conclusion In conclusion, orbital RMS patients treated with chemoradiotherapy, important dental, and facial bone alterations were found. The most significant were in the maxilla and close to the irradiation field. Dental and mandibular bone alterations were also found, indicating the probable chemotherapy action, as this region was not included in the irradiation field.