Skin Surface, Dermis, and Wound Healing

Decker, Roy H.; Strom, Eric A.; Wilson, Lynn D.

doi:10.1007/978-3-540-75863-1_9

Cited by 2 publications

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“…Details of the protocol, patient and treatment characteristics are reported elsewhere (27,28). All dose maps were obtained with a dose grid size of 2.0 × 2.0 × 2.5 mm 3 .…”

Section: Methodsmentioning

confidence: 99%

“…Acute radiation dermatitis (RD), with reactions evident one to four weeks after the beginning of RT, may limit the duration of treatment and the dose delivered (1,2). The severity of adverse dermatologic events ranges from mild erythema to moist desquamation and ulceration, impacting on the quality of a patient's life (3). Acute RD occurs most frequently after RT of breast, pelvic (e.g., anal cancer, vulvar cancer) and head and neck malignancies, while lower incidence is reported for deeper tumors as lung cancers (4).…”

Section: Introductionmentioning

confidence: 99%

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NTCP Models for Severe Radiation Induced Dermatitis After IMRT or Proton Therapy for Thoracic Cancer Patients

et al. 2020

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Radiation therapy (RT) of thoracic cancers may cause severe radiation dermatitis (RD), which impacts on the quality of a patient's life. Aim of this study was to analyze the incidence of acute RD and develop normal tissue complication probability (NTCP) models for severe RD in thoracic cancer patients treated with Intensity-Modulated RT (IMRT) or Passive Scattering Proton Therapy (PSPT). We analyzed 166 Non-Small-Cell Lung Cancer (NSCLC) patients prospectively treated at a single institution with IMRT (103 patients) or PSPT (63 patients). All patients were treated to a prescribed dose of 60 to 74 Gy in conventional daily fractionation with concurrent chemotherapy. RD was scored according to CTCAE v3 scoring system. For each patient, the epidermis structure (skin) was automatically defined by an in house developed segmentation algorithm. The absolute dose-surface histogram (DSH) of the skin were extracted and normalized using the Body Surface Area (BSA) index as scaling factor. Patient and treatment-related characteristics were analyzed. The Lyman-Kutcher-Burman (LKB) NTCP model recast for DSH and the multivariable logistic model were adopted. Models were internally validated by Leave-One-Out method. Model performance was evaluated by the area under the receiver operator characteristic curve, and calibration plot parameters. Fifteen of 166 (9%) patients developed severe dermatitis (grade 3). RT technique did not impact RD incidence. Total gross tumor volume (GTV) size was the only non dosimetric variable significantly correlated with severe RD (p = 0.027). Multivariable logistic modeling resulted in a single variable model including S 20Gy , the relative skin surface receiving more than 20 Gy (OR = 31.4). The cut off for S 20Gy was 1.1% of the BSA. LKB model parameters were TD 50 = 9.5 Gy, m = 0.24, n = 0.62. Both NTCP models showed comparably high prediction and calibration performances. Despite skin toxicity has long been considered a potential limiting factor in the clinical use of PSPT, no significant differences in RD incidence was found between RT modalities. Once externally validated, the availability of NTCP models for prediction of severe RD may advance treatment planning optimization.

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“…Details of the protocol, patient and treatment characteristics are reported elsewhere (27,28). All dose maps were obtained with a dose grid size of 2.0 × 2.0 × 2.5 mm 3 .…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

NTCP Models for Severe Radiation Induced Dermatitis After IMRT or Proton Therapy for Thoracic Cancer Patients

et al. 2020

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Quality of life changes over time and predictors in a large head and neck patients’ cohort: secondary analysis from an Italian multi-center longitudinal, prospective, observational study—a study of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) head and neck working group

Viganò

Felice

Iacovelli

et al. 2023

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Purpose The present study examined the longitudinal trajectories, through hierarchical modeling, of quality of life among patients with head and neck cancer, specifically symptoms burden, during radiotherapy, and in the follow-up period (1, 3, 6, and 12 months after completion of radiotherapy), through the M.D. Anderson Symptom Inventory Head and Neck questionnaire, formed by three factors. Furthermore, analyses were conducted controlling for socio-demographic as well as clinical characteristics. Methods Multi-level mixed-effects linear regression was used to estimate the association between quality of life and time, age, gender, household, educational level, employment status, ECOG performance status, human papilloma virus (HPV) status, surgery, chemotherapy, alcohol intake, and smoking. Results Among the 166 participants, time resulted to be a predictor of all the three questionnaire factors, namely, general and specific related symptoms and interference with daily life. Moreover, regarding symptom interference with daily activities factor, HPV-positive status played a significant role. Considering only HPV-negative patients, only time predicted patients’ quality of life. Differently, among HPV-positive patients, other variables, such as gender, educational level, alcohol use, surgery, age at diagnosis, employment status, and ECOG status, resulted significant. Conclusion It was evident that quality of life of patients with head and neck cancer declined during RT, whereas it slowly improved after ending treatment. Our results clarified the role of some socio-demographic and clinical variables, for instance, HPV, which would allow to develop treatments tailored to each patient.

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Skin Surface, Dermis, and Wound Healing

Cited by 2 publications

References 96 publications

NTCP Models for Severe Radiation Induced Dermatitis After IMRT or Proton Therapy for Thoracic Cancer Patients

NTCP Models for Severe Radiation Induced Dermatitis After IMRT or Proton Therapy for Thoracic Cancer Patients

Quality of life changes over time and predictors in a large head and neck patients’ cohort: secondary analysis from an Italian multi-center longitudinal, prospective, observational study—a study of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) head and neck working group

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