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The device displaces the tongue contralaterally and separates the oral cavity from the target, reducing tongue and oral mucosa radiation dose while maintaining target coverage. Compared with handmade spacers, BinkieRT improves ease of use, hygiene, and reproducibility. Immediate dosimetric gains suggest lower oral toxicity, supporting noninvasive use in diverse clinical settings such as re-irradiation or elderly 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Wang","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What problem does BinkieRT aim to address during IMRT for oral cancer?","Question",{"text":63,"@type":64},"BinkieRT is used to reduce radiation exposure to the tongue and oral mucosa, helping mitigate risks such as radiation-induced mucositis and dysgeusia while preserving target coverage.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was the tongue positioned using BinkieRT in the reported case?",{"text":68,"@type":64},"A C-type BinkieRT device displaced the tongue toward the right, opposite the left buccal mucosa, based on the lesion location.",{"name":70,"@type":61,"acceptedAnswer":71},"How did the clinicians evaluate the dosimetric benefit of BinkieRT?",{"text":72,"@type":64},"Planning CT scans were acquired with and without the device, and dose-volume histograms (DVHs) of the tongue were compared to verify reductions in radiation exposure to critical structures.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},443480,1790795826,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & 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12/02/2025  \nPublished 12/06/2025  \n© Copyright 2025  \nShiojima et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98604  \nOpen Access Case Report  \nA Novel Intensity-Modulated Radiation Therapy Approach to Reduce Tongue Radiation Dose Using the BinkieRT Intraoral Device: A Case Report  \nKanta Shiojima 1, Seiya Isozaki 1, Toshiaki Matsui 1 , Takumi Kodama 1, Shigehiro Kudo 1  \n1. Radiation Oncology, Saitama Cancer Center, Saitama, JPN  \nCorresponding author: Kanta Shiojima, [kshiojima1881@gmail.com](kshiojima1881@gmail.com)  \nAbstract  \nRadiation 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. Wereport 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.  \nCategories: Radiation Oncology  \nKeywords: binkiert, imrt, intensity-modulated radiation therapy, intraoral positioning device, oral cancer, oral mucositis prevention  \nIntroduction  \nRadiation therapy (RT) plays an important role in the management of head and neck cancers, including oral cancer. However, radiation-related adverse events (e.g., oral mucositis, dysphagia, dysgeusia, and  \nxerostomia) remain major clinical concerns. Studies have shown that increased radiation dose to the oral cavity, including the tongue, is associated with the incidence and severity of these adverse events [1-3]. To  \nmitigate these risks, several intraoral devices have been developed to reposition the tongue and spare surrounding healthy tissues [4-6]. This case report describes the dosimetric benefits of using the commercial intraoral positioning device BinkieRT (Paprica Lab., Seoul, Republic of Korea) during intensity-modulated  \nradiation therapy (IMRT) in a patient with recurrent buccal mucosa cancer. We compared dose-volume  \nhistograms (DVHs) of the tongue obtained with and without the device to verify reductions in radiation exposure to critical structures. To the best of our knowledge, no previous studies have compared tongue  \nbody DVHs with and without the use of BinkieRT.  \nCase Presentation  \nThe patient was a 67-year-old man with no remarkable medical or family history. He had a 25-year history  \nof smoking 40 cigarettes per day. Two years prior, he had undergone surgery for left buccal mucosal  \nsquamous cell carcinoma (cT3N0M0, stage III) . At one year and 11 months after surgery, local recurrence was identified in the caudal portion of the reconstructive skin flap, and he was referred to our department for cisplatin-based chemoradiation therapy. At the time of the pr","cbCaigdFFr0ml3Cw","https://ap.wps.com/l/cbCaigdFFr0ml3Cw","pdf",2908051,"English","# Abstract\n# Introduction\n# Case Presentation\n# How to Cite This Article\n# Figures and Ethics Approval","[{\"question\":\"What problem does BinkieRT aim to address during IMRT for oral cancer?\",\"answer\":\"BinkieRT is used to reduce radiation exposure to the tongue and oral mucosa, helping mitigate risks such as radiation-induced mucositis and dysgeusia while preserving target coverage.\"},{\"question\":\"How was the tongue positioned using BinkieRT in the reported case?\",\"answer\":\"A C-type BinkieRT device displaced the tongue toward the right, opposite the left buccal mucosa, based on the lesion location.\"},{\"question\":\"How did the clinicians evaluate the dosimetric benefit of BinkieRT?\",\"answer\":\"Planning CT scans were acquired with and without the device, and dose-volume histograms (DVHs) of the tongue were compared to verify reductions in radiation exposure to critical structures.\"}]","A Novel Intensity-Modulated Radiation Therapy Approach to Reduce Tongue Radiation Dose Using the BinkieRT Intraoral Device - Case Report | PDF",1790704199,18]