NTCP models for patient-rated xerostomia and sticky saliva after treatment with intensity modulated radiotherapy for head and neck cancer: The role of dosimetric and clinical factors

Beetz, Ivo; Schilstra, Cornelis; Schaaf, Arjen van der; Heuvel, Edwin R. van den; Doornaert, P.; Luijk, Peter van; Vissink, Arjan; Laan, Bernard F. A. M. van der; Leemans, C. René; Bijl, H.P.; Christianen, Miranda E.M.C.; Steenbakkers, Roel J.H.M.; Langendijk, Johannes A.

doi:10.1016/j.radonc.2012.03.004

Cited by 160 publications

(168 citation statements)

References 27 publications

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“…Most of the previous studies reported on anatomic and dosimetric changes of the PG. This trend of study can be explained by the fact that radiation dosimetric changes for PGs are associated with saliva reduction and xerostomia 29, 30, 31…”

Section: Discussionmentioning

confidence: 96%

Parotid gland radiation dose‐xerostomia relationships based on actual delivered dose for nasopharyngeal carcinoma

Lou

Huang

et al. 2018

J Applied Clin Med Phys

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Xerostomia induced by radiotherapy is a common toxicity for head and neck carcinoma patients. In this study, the deformable image registration of planning computed tomography (CT) and weekly cone‐beam CT (CBCT) was used to override the Hounsfield unit value of CBCT, and the modified CBCT was introduced to estimate the radiation dose delivered during the course of treatment. Herein, the beams from each patient's treatment plan were applied to the modified CBCT to construct the weekly delivered dose. Then, weekly doses were summed together to obtain the accumulated dose. A total of 42 parotid glands (PGs) of 21 nasopharyngeal carcinoma patients were analyzed. Doses delivered to the parotid glands significantly increased compared with the planning doses. V20, V30, V40, Dmean, and D50 increased by 11.3%, 28.6%, 44.4%, 9.5%, and 8.4% respectively. Of the 21 patients included in the study, eight developed xerostomia and the remaining 13 did not. Both planning and delivered PG Dmean for all patients exceeded tolerance (26 Gy). Among the 21 patients, the planning dose and delivered dose of Dmean were 30.6 Gy and 33.6 Gy, respectively, for patients with xerostomia, and 26.3 Gy and 28.0 Gy, respectively, for patients without xerostomia. The D50 of the planning and delivered dose for patients was below tolerance (30 Gy). The results demonstrated that the p‐value of V20, V30, D50, and Dmean difference of the delivery dose between patients with xerostomia and patients without xerostomia was less than 0.05. However, for the planning dose, the significant dosimetric difference between the two groups only existed in D50 and Dmean. Xerostomia is closely related to V20, V30, D50, and Dmean.

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Section: Discussionmentioning

confidence: 96%

Parotid gland radiation dose‐xerostomia relationships based on actual delivered dose for nasopharyngeal carcinoma

Lou

Huang

et al. 2018

J Applied Clin Med Phys

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“…Variables with Pearson correlation coefficients !0.70 were combined into a single variable (mean dose) to avoid the problem of multicollinearity (24). The dosimetric variables for OM (mean and maximum dose) plus variables listed in Table 1 were used as inputs for multivariate logistic regression to predict g3OM.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Risk of Grade 3 Oral and Pharyngeal Dysphagia Using Atlas-Based Method and Multivariate Analyses of Individual Patient Dose Distributions

Otter

Schick

Gulliford

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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“…This interest for PG changes during radiotherapy can be explained by the fact that radiation dose to the PGs was associated with reduced saliva production [69] and xerostomia [70,71].…”

Section: Parotid Glandmentioning

confidence: 99%

Identifying patients who may benefit from adaptive radiotherapy: Does the literature on anatomic and dosimetric changes in head and neck organs at risk during radiotherapy provide information to help?

Brouwer

Steenbakkers

Langendijk

et al. 2015

Radiotherapy and Oncology

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In the last decade, many efforts have been made to characterize anatomic changes of head and neck organs at risk (OARs) and the dosimetric consequences during radiotherapy. This review was undertaken to provide an overview of the magnitude and frequency of these effects, and to investigate whether we could find criteria to identify head and neck cancer patients who may benefit from adaptive radiotherapy (ART). Possible relationships between anatomic and dosimetric changes and outcome were explicitly considered. A literature search according to PRISMA guidelines was performed in MEDLINE and EMBASE for studies concerning anatomic or dosimetric changes of head and neck OARs during radiotherapy. Fifty-one eligible studies were found. The majority of papers reported on parotid gland (PG) anatomic and dosimetric changes. In some patients, PG mean dose differences between planning CT and repeat CT scans up to 10 Gy were reported. In other studies, only minor dosimetric effects (i.e. <1 Gy difference in PG mean dose) were observed as a result of significant anatomic changes. Only a few studies reported on the clinical relevance of anatomic and dosimetric changes in terms of complications or quality of life. Numerous potential selection criteria for anatomic and dosimetric changes during radiotherapy were found and listed. The heterogeneity between studies prevented unambiguous conclusions on how to identify patients who may benefit from ART in head and neck cancer. Potential pre-treatment selection criteria identified from this review include tumour location (nasopharyngeal carcinoma), age, body mass index, planned dose to the parotid glands, the initial parotid gland volume, and the overlap volume of the parotid glands with the target volume. These criteria should be further explored in well-designed and well-powered prospective studies, in which possible relationships between anatomic and dosimetric changes and outcome need to be established.

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NTCP models for patient-rated xerostomia and sticky saliva after treatment with intensity modulated radiotherapy for head and neck cancer: The role of dosimetric and clinical factors

Abstract: The multivariable NTCP models presented in this paper can be used to predict patient-rated xerostomia and sticky saliva. The dose volume parameters included in the models can be used to further optimise IMRT treatment.

Cited by 160 publications

References 27 publications

Parotid gland radiation dose‐xerostomia relationships based on actual delivered dose for nasopharyngeal carcinoma

Parotid gland radiation dose‐xerostomia relationships based on actual delivered dose for nasopharyngeal carcinoma

Evaluation of the Risk of Grade 3 Oral and Pharyngeal Dysphagia Using Atlas-Based Method and Multivariate Analyses of Individual Patient Dose Distributions

Identifying patients who may benefit from adaptive radiotherapy: Does the literature on anatomic and dosimetric changes in head and neck organs at risk during radiotherapy provide information to help?

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