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

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.