Novel Tongue-Sparing Intraoral Prosthesis Minimizes Radiation Exposure in Submental Sarcoma: Case Report Finds
A recent case report highlights a novel tongue-sparing intraoral prosthesis (TS-IOP) that successfully reduced radiation exposure to the oral tongue during radiotherapy for submental synovial sarcoma.
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.
