Do you constrain dose to the muscles of mastication in definitive and/or post-op HN RT to lower the risk of trismus?
What dose limits do you use and in which situations will you exceed them? How do you counsel your patients on risk of severe trismus and how do you manage it if it occurs?
2 Answers
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Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on
I don't know of any published data on constraints for masseter or pterygoid. While we are on this topic, DARS - a phase III randomised multicentre study of dysphagia- optimised (Do-IMRT) versus S-IMRT in head and neck cancer showed improved swallowing with sparing of constrictor muscles and should b...
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Mednet MemberInvited Expert
Radiation Oncology · Mayo Clinic
Answered on · Updated on
My practice has been to constrain the lateral pterygoids when treating in the vicinity. There are 4 muscles of mastication. The evidence on which is most responsible for radiation-associated trismus has been mixed and retrospective (MD Anderson Head and Neck Cancer Symptom Working Group, Rao et al.,...
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