Novel Tongue-Sparing Intraoral Prosthesis Minimizes Radiation Exposure in Submental Sarcoma: Case Report Finds

The findings of the case report were published in the Indian Journal of Cancer by Dr. Vikas K. Pandey and colleagues from Manipal Hospital Dwarka and BLK-MAX Super Speciality Hospital in Delhi.

A 58-year-old male presenting with a 7 cm × 8 cm submental mass was diagnosed with submental synovial cell sarcoma (TLE1+, CD99+) displacing the tongue without direct muscular invasion. To prevent increased oral tongue radiation dose caused by standard intraoral prosthesis compression, a custom hollow U-shaped tongue-sparing intraoral prosthesis (TS-IOP) was engineered, increasing oral cavity separation volume by 40.9% (from 37.9 cc to 53.4 cc). During neoadjuvant radiotherapy (50 Gy in 25 fractions), dosimetric evaluation demonstrated a 10.3% reduction in mean oral cavity dose (21.0 Gy vs. 23.4 Gy), a 4.5% decrease in maximum spinal cord dose, and an 8.0%–9.3% reduction in mean parotid doses, while maintaining 99.6% PTV V95% coverage. The patient completed radiotherapy with only CTCAE grade 1 oral mucositis and subsequently achieved negative surgical margins.

Implications for Clinicians

The tongue-sparing intraoral prosthesis provides a simple, reproducible technique to minimize tongue irradiation during radiotherapy for floor-of-mouth or submental lesions. By keeping the oral tongue outside high-dose regions without compromising target coverage, this device optimizes the therapeutic ratio and limits acute mucosal toxicity. Further validation in larger cohorts is recommended.

Reference

Pandey, V. K., Munshi, A., & Maria, A. (2026). Use of a novel tongue-sparing intraoral prosthesis for radiation therapy in a head and neck patient: A case report. Indian Journal of Cancer, 63, 200–203.