Dose-response relationship and normal-tissue complication probability of conductive hearing loss in patients undergoing head-and-neck or cranial radiotherapy: A prospective study including 70 ears

Mosleh-Shirazi, Mohammad Amin; Amraee, Azadeh; Mohaghegh, Fathollah

doi:10.1016/j.ejmp.2019.04.003

Cited by 11 publications

(10 citation statements)

References 26 publications

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“…The investigation of patients with medulloblastoma who received concurrent chemotherapy and modern RT procedures revealed that the potential for hearing loss below 35 Gy is essentially non-existent. 17 This is consistent with several NTCP-models [18][19][20] as well as the clinical information from Lee et al, 21 and Wang et al 5…”

Section: Discussionsupporting

confidence: 86%

Assessment of feasibility of cochlear sparing optimized radiotherapy in nasopharyngeal squamous cell carcinoma using high conformal radiation technique

Chandrabose¹,

Balu²,

Balaji³

et al. 2023

Asian J Med Sci

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Background: One of the most prevalent head-and-neck tumors in Southeast Asia is nasopharyngeal carcinoma (NPC). Each year, NPC causes 84,400 new cases and 51,600 fatalities worldwide. Intensity-modulated radiation therapy (IMRT), which has good local control and few side effects on healthy tissue, is being used to treat NPC. Aims and Objectives: Our study aims to assess the feasibility of cochlear sparing using volumetric-modulated arc therapy/IMRT technique. Materials and Methods: Radiotherapy plans of 20 patients diagnosed with NPC who received curative concurrent chemoradiation (Weekly Cisplatin dose of 40 mg/m2) with RT dose of 66 −70 Gy at 1.8–2 Gy/# to a total of 33–35# delivered using True beam LINAC between the year 2020 and 2022 were analyzed retrospectively. Results: Cochlea sparing reoptimization led to a considerable reduction in radiation dose for both cochleae as compared to the original treatment plans. The median D mean and D max for the left and right cochlea was found to be decreased. The difference in planning target volume (PTV)-D mean between the original and reoptimized plans was negligible. After reoptimization, the median PTV CI remained unchanged. The sparing of the left and right parotids and brain stem was not improved by reoptimization. A similar event was noted for the spinal cord, where the change from the median D max was not statistically significant. Conclusion: Our investigation showed that a much-increased cochlea sparing is possible in the majority of patients while maintaining PTV dosage coverage and the other organs at risk. Clinical trials in the future, both retrospective and prospective, should examine the effects of this optimization.

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Section: Discussionsupporting

confidence: 86%

Assessment of feasibility of cochlear sparing optimized radiotherapy in nasopharyngeal squamous cell carcinoma using high conformal radiation technique

Chandrabose¹,

Balu²,

Balaji³

et al. 2023

Asian J Med Sci

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“…The corresponding curve versus EUD is a well-behaved sigmoid for the CCCS algorithm (figure 2). The same figure also shows some degree of fluctuation in the FPEP data, due to the fact that the EUD axis was derived from the doses calculated by another algorithm, namely CCCS, and not its own dose calculations, which gave a smooth curve (32,43) .…”

Section: Discussionmentioning

confidence: 91%

“…The LKB model is well-established in NTCP calculation (31,(40)(41)(42) . BioSuite is a reliable software that has found increasing use in NTCP modeling studies (43)(44)(45)(46) .…”

Section: Radiobiological Modelingmentioning

confidence: 99%

Equivalent uniform dose and normal tissue complication probability of acute esophagitis in head-and-neck radiotherapy: Sensitivity to dose calculation accuracy

Mosleh-Shirazi

Sheikholeslami²,

Fathipour³

et al. 2022

Int J Radiat Res

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Background: To quantify the influence of photon dose-calculation algorithm selection on the cervical esophagus (CE) dose indices and the derived equivalent uniform dose (EUD) and normal-tissue complication probability (NTCP) for acute esophagitis in patients with head-and-neck cancer (HNC). Materials and Methods: The Fast Photon Effective Path (FPEP) and Collapsed-Cone Convolution Superposition (CCCS) algorithms on the Prowess Panther treatment planning system were compared for 30 patients (six tumor sites). The Lyman-Kutcher-Burmann (LKB) model was used to calculate the EUDs and NTCPs. Results: On average, the more simplistic FPEP algorithm overestimated the mean dose to CE planning organ-at-risk volumes (PRVs) by 2.0% (p = 0.003). The average absolute difference in mean dose was 2.7% and the maximum difference was 9.3%. The V 5Gy , V 10Gy , V 15Gy , V 20Gy , V 25Gy and V 30Gy values were significantly higher with FPEP, while the point-dose and D 2cc hot spots were similar. In turn, the dose differences led to an underestimation of the LKB-model prediction of the EUD by 1.4% (p = 0.297). The mean absolute difference in EUD was 4.5% and the maximum difference was 15.3%. In the 14-50 Gy mean dose range, the resulting NTCPs with FPEP were lower on average by 2.6% than CCCS (p = 0.041). Conclusions: In the group of HNC patients considered in this study, the EUD and NTCP for acute esophagitis showed to be moderately sensitive to the choice of dose-calculation algorithm. Despite an overestimated mean dose by the simpler algorithm, the NTCP underestimation, which can be large in some patients, is of clinical concern.

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“…In the present study, there was no significant association between the incidence of ≥ G2 hearing impaired and the course of cisplatin (data not shown). Impaired hearing after head and neck chemoradiation therapy is well documented, and dose–response relationships were reported in several papers [ 11 – 14 ]. In the present analysis, ≥ G2 hearing impaired was significantly associated with the mean dose to the ipsilateral inner ear ≥ 44.0 Gy (p = 0.041).…”

Section: Discussionmentioning

confidence: 99%

Organs-at-risk dose constraints in head and neck intensity-modulated radiation therapy using a dataset from a multi-institutional clinical trial (JCOG1015A1)

Inada

Nishimura

Ishikura³

et al. 2022

Radiat Oncol

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Background JCOG1015A1 is an ancillary research study to determine the organ-specific dose constraints in head and neck carcinoma treated with intensity-modulated radiation therapy (IMRT) using data from JCOG1015. Methods Individual patient data and dose-volume histograms of organs at risk (OAR) were collected from 74 patients with nasopharyngeal carcinoma treated with IMRT who enrolled in JCOG1015. The incidence of late toxicities was evaluated using the cumulative incidence method or prevalence proportion. ROC analysis was used to estimate the optimal DVH cut-off value that predicted toxicities. Results The 5-year cumulative incidences of Grade (G) 1 myelitis, ≥ G1 central nervous system (CNS) necrosis, G2 optic nerve disorder, ≥ G2 dysphagia, ≥ G2 laryngeal edema, ≥ G2 hearing impaired, ≥ G2 middle ear inflammation, and ≥ G1 hypothyroidism were 10%, 5%, 2%, 11%, 5%, 26%, 34%, and 34%, respectively. Significant associations between DVH parameters and incidences of toxicities were observed in the brainstem for myelitis (D1cc ≥ 55.8 Gy), in the brain for CNS necrosis (D1cc ≥ 72.1 Gy), in the eyeball for optic nerve disorder (Dmax ≥ 36.6 Gy), and in the ipsilateral inner ear for hearing impaired (Dmean ≥ 44 Gy). The optic nerve, pharyngeal constrictor muscle (PCM), and thyroid showed tendencies between DVH parameters and toxicity incidence. The prevalence proportion of G2 xerostomia at 2 years was 17 versus 6% (contralateral parotid gland Dmean ≥ 25.8 Gy vs less). Conclusions The dose constraint criteria were appropriate for most OAR in this study, although more strict dose constraints might be necessary for the inner ear, PCM, and brainstem.

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Dose-response relationship and normal-tissue complication probability of conductive hearing loss in patients undergoing head-and-neck or cranial radiotherapy: A prospective study including 70 ears

Cited by 11 publications

References 26 publications

Assessment of feasibility of cochlear sparing optimized radiotherapy in nasopharyngeal squamous cell carcinoma using high conformal radiation technique

Assessment of feasibility of cochlear sparing optimized radiotherapy in nasopharyngeal squamous cell carcinoma using high conformal radiation technique

Equivalent uniform dose and normal tissue complication probability of acute esophagitis in head-and-neck radiotherapy: Sensitivity to dose calculation accuracy

Organs-at-risk dose constraints in head and neck intensity-modulated radiation therapy using a dataset from a multi-institutional clinical trial (JCOG1015A1)

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