# A Novel Intensity-Modulated Radiation Therapy Approach to Reduce Tongue Radiation Dose Using the BinkieRT Intraoral Device: A Case Report

## TL;DR

A new device called BinkieRT helps reduce radiation dose to the tongue during oral cancer treatment, potentially improving patient quality of life.

## Contribution

The BinkieRT intraoral device is introduced as a novel, practical solution to reduce tongue radiation dose during IMRT for oral cancer.

## Key findings

- BinkieRT displaced the tongue and reduced radiation dose to the tongue and oral mucosa without affecting target coverage.
- BinkieRT offers advantages over handmade spacers in terms of ease of use, hygiene, and reproducibility.
- The device's design is noninvasive and suitable for various clinical scenarios, including elderly patients and re-irradiation cases.

## Abstract

Radiation therapy plays a pivotal role in the management of oral cancer. However, radiation-induced mucositis and dysgeusia frequently impair patients’ quality of life. To mitigate these risks, intraoral positioning devices have been introduced to minimize radiation exposure to the oral organs at risk. We report a case of recurrent buccal mucosa cancer treated with intensity-modulated radiation therapy (IMRT) using a commercial intraoral device, BinkieRT (Paprica Lab., Seoul, Republic of Korea). The device displaced the tongue contralaterally and separated the oral cavity from the target volume, leading to a reduction in radiation dose to the tongue and oral mucosa without compromising target coverage. Compared with handmade spacers or bite blocks, BinkieRT offers distinct advantages in terms of ease of use, hygiene, and reproducibility. The observed immediate dosimetric improvement indicates the potential to reduce the incidence and severity of radiation-induced oral toxicity. Its noninvasive and patient-friendly design also makes it applicable to a wide range of clinical situations, including re-irradiation cases or elderly patients with limited tolerance. BinkieRT provides a simple and practical approach to reduce unnecessary radiation exposure in oral cancer IMRT. Further clinical studies are warranted to validate its efficacy and establish optimal usage protocols.