Normal tissue complication probability (NTCP) modelling using spatial dose metrics and machine learning methods for severe acute oral mucositis resulting from head and neck radiotherapy

Dean, Jamie; Wong, Kee H.; Welsh, Liam; Jones, Ann-Britt; Schick, Ulrike; Newbold, Kate; Bhide, Shreerang A.; Harrington, Kevin; Nutting, Christopher M.; Gulliford, S.

doi:10.1016/j.radonc.2016.05.015

Cited by 88 publications

(69 citation statements)

References 46 publications

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“…In the absence of randomised data though, it remains contentious whether any perceived benefits justify the high capital investment protons require, particularly in the current environment of stringent healthcare budgets. Strategies involving deescalation of chemotherapy and radiotherapy [56], improving management of acute toxicities [57,58], using functional imaging to adapt radiotherapy [59], strengthening collaboration with speech and language therapists and dietetics to facilitate timely swallowing interventions and evaluating novel drugeradiotherapy combinations are some of the key measures that need to be incorporated to ultimately devise a successful personalised toxicitymitigating approach in pharyngeal cancer.…”

Section: Resultsmentioning

confidence: 99%

Dysphagia-optimised Intensity-modulated Radiotherapy Techniques in Pharyngeal Cancers: Is Anyone Going to Swallow it?

et al. 2017

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Dysphagia after primary chemoradiotherapy or radiation alone in pharyngeal cancers can have a devastating impact on a patient's physical, social and emotional state. Establishing and validating efficient dysphagia-optimised radiotherapy techniques is, therefore, of paramount importance in an era where health-related quality of life measures are increasingly influential determinants of curative management strategies, particularly as the incidence of good prognosis, human papillomavirus-driven pharyngeal cancer in younger patients continues to rise. The preferential sparing achievable with intensity-modulated radiotherapy (IMRT) of key swallowing structures implicated in post-radiation dysfunction, such as the pharyngeal constrictor muscles (PCM), has generated significant research into toxicity-mitigating strategies. The lack of randomised evidence, however, means that there remains uncertainty about the true clinical benefits of the dosimetric gains offered by technological advances in radiotherapy. As a result, we feel that IMRT techniques that spare PCM cannot be incorporated into routine practice. In this review, we discuss the swallowing structures responsible for functional impairment, analyse the studies that have explored the dose-response relationship between these critical structures and late dysphagia, and consider the merits of reported dysphagia-optimised IMRT (Do-IMRT) approaches, thus far. Finally, we discuss the dysphagia/aspiration-related structures (DARS) study (ISRCTN 25458988), which is the first phase III randomised controlled trial designed to investigate the impact of swallow-sparing strategies on improving long-term function. To maximise patient benefits, improvements in radiation delivery will need to integrate with novel treatment paradigms and comprehensive rehabilitation strategies to eventually provide a patient-centric, personalised treatment plan.

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Section: Resultsmentioning

confidence: 99%

Dysphagia-optimised Intensity-modulated Radiotherapy Techniques in Pharyngeal Cancers: Is Anyone Going to Swallow it?

et al. 2017

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“…We summarized various clinical applications such as head, neck, lung, and prostate cancer using machine learning algorithm in radiation oncology [13,18,19]. And those machine learning algorithm introductions and several definitions were listed.…”

Section: Resultsmentioning

confidence: 99%

Predictive Solution for Radiation Toxicity Based on Big Data

Lee¹,

Kim²,

Woo³

et al. 2017

Radiotherapy

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Radiotherapy is a treatment method using radiation for cancer treatment based on a patient treatment planning for each radiotherapy machine. At this time, the dose, volume, device setting information, complication, tumor control probability, etc. are considered as a single-patient treatment for each fraction during radiotherapy process. Thus, these filed-up big data for a long time and numerous patients' cases are inevitably suitable to produce optimal treatment and minimize the radiation toxicity and complication. Thus, we are going to handle up prostate, lung, head, and neck cancer cases using machine learning algorithm in radiation oncology. And, the promising algorithms as the support vector machine, decision tree, and neural network, etc. will be introduced in machine learning. In conclusion, we explain a predictive solution of radiation toxicity based on the big data as treatment planning decision support system.

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“…ARM usually occurs during or soon after irradiation of patients with head and neck tumors. The study of ARM is a subject of interest in the field of radiation therapy physics [7]. According to a previously reported systematic review, there is neither an established treatment for ARM nor a consensus protocol for preventing ARM [8].…”

Section: Discussionmentioning

confidence: 99%

Customized mouthpieces designed to reduce tongue mucositis in carbon-ion radiotherapy for tumors of the nasal and paranasal sinuses

Saitoh

Shirai

Kubota

et al. 2017

Physics and Imaging in Radiation Oncology

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Mouthpieces are used to fix the positions of the lower jaw and teeth during carbon-ion radiotherapy for head and neck tumors. We used a customized mouthpiece to reduce radiation mucositis by displacing the tongue. Acute radiation mucositis gradually increased for the palate and tongue after approximately six irradiation fractions (maximal mean grade: palate, 2.5 during radiation fractions 15; tongue, 0.8 during radiation fractions 12 and 13). The mean grade of mucositis was significantly lower for the tongue than for the palate from irradiation fraction six until two weeks after irradiation.

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Normal tissue complication probability (NTCP) modelling using spatial dose metrics and machine learning methods for severe acute oral mucositis resulting from head and neck radiotherapy

Abstract: The RFCstandard model performance is modest-to-good, but should be improved, and requires external validation. Reducing the volumes of oral cavity receiving intermediate and high doses may reduce mucositis incidence.

Cited by 88 publications

References 46 publications

Dysphagia-optimised Intensity-modulated Radiotherapy Techniques in Pharyngeal Cancers: Is Anyone Going to Swallow it?

Dysphagia-optimised Intensity-modulated Radiotherapy Techniques in Pharyngeal Cancers: Is Anyone Going to Swallow it?

Predictive Solution for Radiation Toxicity Based on Big Data

Customized mouthpieces designed to reduce tongue mucositis in carbon-ion radiotherapy for tumors of the nasal and paranasal sinuses

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