ESTRO 2025 - Abstract Book

S1643

Clinical – äediatric tumours

ESTRO 2025

3502

Poster Discussion Systematic review of facial deformation following paediatric head-and-neck radiotherapy: A call for standardised outcomes and dose-response evidence. Angela Davey 1 , Lucy S C Davies 2 , Koen B Krommenhoek 3 , Emma Foster-Thomas 4 , Nanouschka H Maagdenberg 5 , Frances Charlwood 6 , Simona Gaito 6 , Love Goyal 7 , Callum Gillies 8 , Olga Slater 9 , Bernadette Brennan 10 , Danny Indelicato 11 , Shermaine Pan 12 , Marinka Hol 13 , Marianna C Aznar 14 1 Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom. 2 Department of Radiotherapy, The Christie NHS Foundation Trust, Manchester, United Kingdom. 3 Department of Maxillofacial Surgery, ACTA (Academisch Centrum Tandheelkunde Amsterdam), Amsterdam, Netherlands. 4 Restorative Dentistry Department, The University of Manchester, Manchester, United Kingdom. 5 Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, Netherlands. 6 Department of Proton Therapy, The Christie NHS Foundation Trust, Manchester, United Kingdom. 7 Department of Radiation Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom. 8 Department of Medical Physics and Biomedical Engineering, University College London Hospitals, London, United Kingdom. 9 Department of Haematology and Oncology, Great Ormond Street Hospital, London, United Kingdom. 10 Department of Oncology, Royal Manchester Children's Hospital, Manchester, United Kingdom. 11 Department of Radiation Oncology, University of Florida Health, Florida, USA. 12 Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom. 13 Department of Maxillofacial Surgery, Princess maxima Center for Paediatric Oncology, Utrecht, Netherlands. 14 Divsion of Cancer Sciences, The University of Manchester, Manchester, United Kingdom Purpose/Objective: Radiotherapy is an essential treatment for childhood head-and-neck cancer. Children whose facial tissues are irradiated during developmental years are at risk of dentofacial toxicity, e.g. facial deformation (FD), which is linked to reduced quality of life and functional effects (e.g., trismus). In routine practice, efforts should be made to minimise dose to dentofacial bones and tissues where possible, however, there are no agreed dose constraints for dentofacial structures. A recent international survey has highlighted a disparity in clinical practice and a need for consensus on dose assessment of dentofacial structures 1 . In this review we aim to evaluate: 1) the reported level of FD, 2) current dose-response evidence, and 3) common outcome measures/grading systems. Material/Methods: Studies were identified following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Embase (Ovid), PubMed and the Cochrane Library were queried from the earliest publications to July 2023. The query captured disease: “cancer in the head and neck area”, population: “children”, intervention: “radiotherapy”, and outcome: “dentofacial deformation”. Three authors independently reviewed all titles and abstracts, following the same inclusion and exclusion criteria. Conflicts were resolved through discussion. Two authors screened full-texts, and all co-authors were paired to perform and review data extraction individually. We separated dental and facial effects for individual analyses and studied only FD in this abstract. Results: Out of 1916 identified articles 21 reported on FD in the relevant population. These articles were published between 1983 - 2023 and studied a median (range) of 26 (8 - 192) patients. The median age at treatment across studies was 4.9 (0.3 - 13) years, with a full range of 0 - 21 years. The average follow-up was 8.25 (0.2 – 20) years since treatment. Seven articles studied dose-response, evidencing the role of dose, age, and tumour laterality (Figure 1).