MRI-based adaptive radiotherapy has the potential to reduce dysphagia in patients with head and neck cancer

J, Grepl; Sirák, Igor; Vošmik, Milan; Pohanková, Denisa; Hodek, Miroslav; Paluska, Petr; Tichý, Aleš

doi:10.1016/j.ejmp.2022.12.003

Cited by 3 publications

(2 citation statements)

References 53 publications

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“…This seminal work compared dysphagia-optimized radiotherapy (DORT) and MRI-based adaptative dysphagia-optimized radiotherapy (DOART) plans retrospectively, and captured weekly MRI-signal changes and volumetric changes for key swallowing structures, including the pharyngeal constrictor muscles, cricopharyngeal muscles, proximal part of the oesophagus, supraglottic larynx and transglottic larynx. Findings demonstrated that MRI-based DOART yielded numerous benefits, with significant reduction in mean doses to DARS without compromise to target volumes, positive impacts to MRI signal intensity and volumetric changes to normal tissues, and associated improvements to functional swallowing outcomes [22 ▪ ]. Whilst these findings are promising, they must be interpreted with caution, as understanding dose-adaptation with regards to long-term tumour locoregional control is in its early stages.…”

Section: Imaging In Dysphagiamentioning

confidence: 99%

“…In addition, work by Grepl et al [22 ▪ ], have specifically investigated the feasibility of using MRI-based adaptive radiotherapy to spare key swallowing structures (known as dysphagia/aspiration-related structures, DARS), known to have high-risk, dose-dependent associations with swallowing outcomes [23]. This seminal work compared dysphagia-optimized radiotherapy (DORT) and MRI-based adaptative dysphagia-optimized radiotherapy (DOART) plans retrospectively, and captured weekly MRI-signal changes and volumetric changes for key swallowing structures, including the pharyngeal constrictor muscles, cricopharyngeal muscles, proximal part of the oesophagus, supraglottic larynx and transglottic larynx.…”

Section: Imaging In Dysphagiamentioning

confidence: 99%

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Advances in and applications of imaging and radiomics in head and neck cancer survivorship

Wishart

Ward

Galloway

2023

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of Review Radiological imaging is an essential component of head/neck cancer (HNC) care. Advances in imaging modalities (including CT, PET, MRI and ultrasound) and analysis have enhanced our understanding of tumour characteristics and prognosis. However, the application of these methods to evaluate treatment-related toxicities and functional burden is still emerging. This review showcases recent literature applying advanced imaging and radiomics to the assessment and management of sequelae following chemoradiotherapy for HNC. Recent findings Whilst primarily early-stage/exploratory studies, recent investigations have showcased the feasibility of using radiological imaging, particularly advanced/functional MRI (including diffusion-weighted and dynamic contrast-enhanced MRI), to quantify treatment-induced tissue change in the head/neck musculature, and the clinical manifestation of lymphoedema/fibrosis and dysphagia. Advanced feature analysis and radiomic studies have also begun to give specific focus to the prediction of functional endpoints, including dysphagia, trismus and fibrosis. Summary There is demonstrated potential in the use of novel imaging techniques, to help better understand pathophysiology, and improve assessment and treatment of functional deficits following HNC treatment. As larger studies emerge, technologies continue to progress, and pathways to clinical translation are honed, the application of these methods offers an exciting opportunity to transform clinical practices and improve outcomes for HNC survivors.

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Section: Imaging In Dysphagiamentioning

confidence: 99%

Section: Imaging In Dysphagiamentioning

confidence: 99%

Advances in and applications of imaging and radiomics in head and neck cancer survivorship

Wishart

Ward

Galloway

2023

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Probabilistic evaluation of plan quality for time-dependent anatomical deformations in head and neck cancer patients

Robbins¹,

Herk²,

Eiben³

et al. 2023

Physica Medica

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Delineation of the “Oropharyngeal Mucosa” and Limiting its Dose in Head and Neck Cancer Patients Spares the Oropharynx Without Compromising Target Coverage

Wang,

Han,

Zhi

et al. 2024

Cancer Control

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Objectives Radiation-induced oropharyngeal injury is a dose-limiting toxicity in head and neck cancer patients. Delineation of the “oropharyngeal mucosa” and limiting its dose to spare the oropharynx was investigated. Methods In this retrospective study, computed tomography imaging from eight patients with previously untreated head and neck cancer was employed. An adaptive contouring brush within the planning software Monaco was used to create an air cavity within the oropharynx, and then the air cavity was expanded uniformly 2 mm to create the “oropharyngeal mucosa”. Three plans were independently generated for each patient: Plan1: dose constraint was applied for the oropharynx; Plan2: dose constraints were applied for the oropharynx and the “oropharyngeal mucosa”; Plan3: dose constraint was applied for the “oropharyngeal mucosa”. T-tests were used to compare the dosimetry variables. Results All plans had adequate target coverage and there were no statistical differences among plans. The mean dose, D30%, D45%, D50%, D85%, D90%, D95%, D100%, V25 Gy, V30 Gy, V35 Gy, V40 Gy, and V45 Gy of the oropharynx and “oropharyngeal mucosa” in Plan1 were significantly higher than those in Plan2 and Plan3. There were no significant differences between Plan2 and Plan3. There were no significant differences in the dosimetric parameters of any other organs at risk. Conclusion Delineation of the “oropharyngeal mucosa” and limiting its dose should be an easy and effective method to spare the oropharynx.

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MRI-based adaptive radiotherapy has the potential to reduce dysphagia in patients with head and neck cancer

Cited by 3 publications

References 53 publications

Advances in and applications of imaging and radiomics in head and neck cancer survivorship

Advances in and applications of imaging and radiomics in head and neck cancer survivorship

Probabilistic evaluation of plan quality for time-dependent anatomical deformations in head and neck cancer patients

Delineation of the “Oropharyngeal Mucosa” and Limiting its Dose in Head and Neck Cancer Patients Spares the Oropharynx Without Compromising Target Coverage

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