Systematic Review of Late Dental Effects Following Head and Neck Radiation Therapy in Childhood Cancer Survivors
Year: 2026
Type: review
Study design: Systematic Review
Abstract: PURPOSE: Childhood cancer survivors face an increased risk of dental anomalies with both chemotherapy and radiation therapy (RT) contributing to these late adverse effects (AEs), particularly when RT doses >20 Gy are delivered. This systematic review aims to: (1) provide an overview of late dental AEs reported after childhood RT, (2) report the prevalence of these AEs in survivors who received head and/or neck RT during childhood, and (3) describe dose-response evidence and the use of AE grading protocols. METHODS AND MATERIALS: A comprehensive search was conducted in Embase and PubMed. Extracted data included study characteristics, treatment details, and outcomes. Heterogeneity was assessed qualitatively, and risk of bias was evaluated using the Cochrane Childhood Cancer tool. RESULTS: Forty-four studies published between 1985 and 2024 were included, comprising 7299 participants (age range 3-16.5 years). The median prescribed RT dose was 50.4 Gy (range 10.0-67.5 Gy), with a median follow-up of 8.35 years. Reported dental AEs included agenesis, microdontia, and root stunting. Higher prescribed radiation doses were associated with increased AE risk. Dental outcomes were assessed clinically and radiographically. CONCLUSIONS: There is a clear need for standardized definitions, assessment methods, grading criteria, and data reporting for late dental AEs in childhood head and/or neck cancer survivors. Accurate documentation of RT regimens and pretreatment dental status is essential to support dose minimization strategies, tailored patient education, and long-term dental follow-up, ultimately improving survivorship care.
Source: Practical Radiation Oncology
Authors: Koen B. Krommenhoek, Emma Foster-Thomas, Angela Davey, Lucy Siew Chen Davies, Nanouschka H. Maagdenberg, Frances Charlwood, Simona Gaito, Love Goyal, Callum Gillies, Olga Slater, Bernadette Brennan, Mark N. Gaze, Cynthia L. Eccles, Alfred G. Becking, Johannes H.M. Merks, Henry C. Mandeville, Daniel J. Indelicato, Matthew Krasin, Shermaine Pan, Marianne C. Aznar, Marinka L.F. Hol
Institutions: Academic Center for Dentistry Amsterdam, Princess Máxima Center, Amsterdam University Medical Centers, University of Amsterdam, University of Manchester, Manchester University NHS Foundation Trust, The Christie NHS Foundation Trust, Utrecht University, University Medical Center Utrecht, University College Hospital, University College London Hospitals NHS Foundation Trust, Great Ormond Street Hospital, Great Ormond Street Hospital for Children NHS Foundation Trust, Royal Manchester Children's Hospital, Institute of Cancer Research, Royal Marsden Hospital, University of Florida, University of Florida Health Science Center, St. Jude Children's Research Hospital
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $2,700
Funders: Children's Cancer Research Fund, Cancer Research UK, National Institute for Health and Care Research, Institute of Cancer Research, University of Manchester, Cancer Research UK Manchester Centre, Manchester Biomedical Research Centre, Engineering and Physical Sciences Research Council, Research England
Awards: Big data for small patients - Building "child-size" individual predictive models for life after childhood cancer, G1798610363, G4869084219, Facial Asymmetry in Childhood Cancer Survivors Treated with Radiotherapy, Enabling dentofacial toxicity reporting in childhood cancer survivors treated with proton beam therapy for head and neck cancer in the UK and overseas: Development of a novel prospective toxicity reporting tool. [Short title: DENtofacial TOxicity: Facilitating Advancement in paediatric Cancer toxIcity reporting And Liaison in Proton Beam Therapy (DENTOFACIAL-PBT)], G8807413798
OpenAlex ID: W7130559044