# Proton beam therapy and dentofacial development in paediatric cancer patients: A scoping review

## TL;DR

This review explores how proton beam therapy affects facial and dental development in children with head and neck cancers.

## Contribution

The study identifies a gap in understanding dentofacial toxicity in pediatric cancer patients treated with proton beam therapy.

## Key findings

- Only 11 studies were identified, with poor reporting and limited patient data.
- Dentofacial development disturbances are under-reported in pediatric cancer survivors treated with proton beam therapy.
- More research is needed on how treatment age, dose, and therapies affect facial and dental outcomes.

## Abstract

It is known that radiation to dentofacial structures during childhood can lead to developmental disturbances. However, this appears to be a relatively subordinated research subject. For this reason, this review aims to establish the current evidence base on the effect of PBT on dentofacial development in paediatric patients treated for cancer in the head and neck region.

A comprehensive search was undertaken to identify both published and unpublished studies or reports. A single reviewer completed initial screening of abstracts; 2 independent reviewers completed secondary screening and data extraction. A narrative synthesis was then conducted.

82 records were screened in total, resulting in 11 included articles. These articles varied in terms of study design and reporting quality. Owing to both poor study reporting and limited patient numbers, it is not possible to determine the effect of cancer diagnosis, chronological age at treatment, radiation dose or treatment modality on the incidence of facial deformation or dental development anomalies.

Disturbances in dentofacial development are an under-reported toxicity in paediatric cancer survivors treated with PBT to the head and neck. There is a need for more research on dentofacial toxicity reporting, focused on the impact of treatment age, radiation dose, concurrent therapies, and the subsequent impact on quality of life.