Dental and craniofacial alterations in long-term survivors of childhood head and neck rhabdomyosarcoma

Oral Surg Oral Med Oral Pathol Oral Radiol. 2019 Apr;127(4):272-281. doi: 10.1016/j.oooo.2018.12.012. Epub 2018 Dec 21.

Abstract

Objective: Rhabdomyosarcoma (RMS) represents the most common soft tissue sarcoma that affects children. Treatment involves chemoradiotherapy. This study aimed at evaluating the long-term alterations to teeth and cranial bones in children, teenagers, and young adults after oncologic treatment.

Study design: We conducted a cross-sectional study of patients undergoing treatment for head and neck RMS between 1988 and 2011. We evaluated demographic, clinical, and treatment data and performed panoramic radiography, cephalometry, and photography.

Results: We evaluated 27 long-term survivors, most of whom had been treated between ages 0 to 5 years (51.9%). The total radiation dose applied was 50.4 Gy, and the chemotherapy combination included vincristine, actinomycin D, and cyclophosphamide in 51.9% of the cases. We observed 603 dental alterations, among which 377 (62.7%) occurred in patients ages 0 to 5 years, and root shortening was the most frequent alteration observed (24.2%). With regard to facial bones, 74% of the patients had some level of facial asymmetry, 70.4% had reduced facial depth, 48.4% had mandibles of short size, and 77.8% had reduced facial height.

Conclusions: Children submitted to RMS treatment involving chemotherapy and radiotherapy displayed significant dental and craniofacial alterations, especially when treatment occurred between ages 0 and 5 years.

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols
  • Chemoradiotherapy
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Craniofacial Abnormalities* / etiology
  • Cross-Sectional Studies
  • Dentition*
  • Head and Neck Neoplasms* / complications
  • Head and Neck Neoplasms* / therapy
  • Humans
  • Infant
  • Infant, Newborn
  • Rhabdomyosarcoma* / complications
  • Rhabdomyosarcoma* / therapy
  • Survivors
  • Young Adult