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Impact of radiation and chemotherapy on risk of dental abnormalities

A report from the Childhood Cancer Survivor Study

  1. Sue C. Kaste DO1,2,3,†,*,
  2. Pamela Goodman MS4,
  3. Wendy Leisenring ScD4,5,
  4. Marilyn Stovall PhD6,
  5. Robert J. Hayashi MD7,
  6. Mark Yeazel MD8,
  7. Soraya Beiraghi DDS9,
  8. Melissa M. Hudson MD2,10,
  9. Charles A. Sklar MD11,
  10. Leslie L. Robison PhD10,
  11. K. Scott Baker MD, MS4

Article first published online: 15 OCT 2009

DOI: 10.1002/cncr.24670

Issue

Cancer

Cancer

Volume 115, Issue 24, pages 5817–5827, 15 December 2009

Additional Information

How to Cite

Kaste, S. C., Goodman, P., Leisenring, W., Stovall, M., Hayashi, R. J., Yeazel, M., Beiraghi, S., Hudson, M. M., Sklar, C. A., Robison, L. L. and Baker, K. S. (2009), Impact of radiation and chemotherapy on risk of dental abnormalities. Cancer, 115: 5817–5827. doi: 10.1002/cncr.24670

Author Information

  1. 1

    Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee

  2. 2

    Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee

  3. 3

    Department of Radiology, University of Tennessee School of Health Sciences, Memphis, Tennessee

  4. 4

    Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, Washington

  5. 5

    Clinical Statistics Program, Fred Hutchinson Cancer Research Center, Seattle, Washington

  6. 6

    Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas

  7. 7

    Department of Pediatrics, Washington University, St. Louis, Missouri

  8. 8

    Department of Family Medicine and Community Heath, University of Minnesota, Minneapolis, Minnesota

  9. 9

    Department of Developmental and Surgical Science, University of Minnesota, Minneapolis, Minnesota

  10. 10

    Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee

  11. 11

    Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York

  1. †

    Fax: (901) 595-3981

*Department of Radiological Sciences, St. Jude Children's Research Hospital, MS 220, 262 Danny Thomas Place, Memphis, TN 38105

  1. †

    Fax: (901) 595-3981

Publication History

  1. Issue published online: 2 DEC 2009
  2. Article first published online: 15 OCT 2009
  3. Manuscript Accepted: 5 MAR 2009
  4. Manuscript Received: 10 JAN 2009

Funded by

  • Department of Health and Human Services. Grant Number: U24-CA-55727
  • Children's Cancer Research Fund
  • American Lebanese Syrian Associated Charities

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Keywords:

  • radiation;
  • chemotherapy;
  • pediatric oncology;
  • dental abnormalities

Abstract

BACKGROUND:

The current study was performed to describe frequencies and risk factors of altered oral health and odontogenesis in childhood cancer survivors.

METHODS:

In total, 9308 survivors who were diagnosed between 1970 and 1986 and 2951 siblings from the Childhood Cancer Survivor Study completed a survey that contained oral-dental health information. The authors analyzed treatment impact, socioeconomic data, and patient demographics on dental outcomes using univariate and multivariate logistic regression models to estimate odds ratios (ORs).

RESULTS:

In multivariate analysis, survivors were more likely to report microdontia (OR, 3.0; 95% confidence interval [95% CI], 2.4-3.8), hypodontia (OR, 1.7; 95% CI, 1.4-2.0), root abnormalities (OR, 3.0; 95% CI, 2.2-4.0), abnormal enamel (OR, 2.4; 95% CI, 2.0-2.9), teeth loss ≥6 (OR, 2.6; 95% CI, 1.9-3.6), severe gingivitis (OR, 1.2; 95% CI, 1.0-1.5), and xerostomia (OR, 9.7; 95% CI, 4.8-19.7). Controlling for chemotherapy and socioeconomic factors, radiation exposure of ≥20 Gray to dentition was associated significantly with an increased risk of ≥1 dental abnormality. Dose-dependent alkylating agent therapy significantly increased the risk of ≥1 anatomic/developmental dental abnormalities in survivors who were diagnosed at age <5 years (OR, 1.7, 2.7, and 3.3 for alkylating agent scores of 1, 2, and 3, respectively).

CONCLUSIONS:

Radiation and chemotherapy were independent risk factors for adverse oral-dental sequelae among childhood cancer survivors. The authors concluded that patients who received receiving alkylating agents at age <5 years should be closely monitored. Cancer 2009. © 2009 American Cancer Society.

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