Selection of head and neck cancer patients for adaptive radiotherapy to decrease xerostomia

详细信息    查看全文

• 作者：Charlotte L. Brouwer^a ; ^{c.l.brouwer@umcg.nl" class="auth_mail" title="E-mail the corresponding author} ; Roel J.H.M. Steenbakkers^a ; Arjen van der Schaaf^a ; Chantal T.C. Sopacua^a ; Lisanne V. van Dijk^a ; Roel G.J. Kierkels^a ; Hendrik P. Bijl^a ; Johannes G.M. Burgerhof^b ; Johannes A. Langendijk^a ; Nanna M. Sijtsema^a
• 关键词：Head and neck ; Parotid glands ; Dosimetric changes ; Adaptive radiotherapy ; Patient selection ; Xerostomia
• 刊名：Radiotherapy and Oncology
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：120
• 期：1
• 页码：36-40
• 全文大小：476 K

文摘

The aim of this study was to develop and validate a method to select head and neck cancer patients for adaptive radiotherapy (ART) pre-treatment. Potential pre-treatment selection criteria presented in recent literature were included in the analysis.

Materials and methods

Deviations from the planned parotid gland mean dose (PG ΔDmean) were estimated for 113 head and neck cancer patients by re-calculating plans on repeat CT scans. Uni- and multivariable linear regression analyses were performed to select pre-treatment parameters, and ROC curve analysis was used to determine cut off values, for selecting patients with a PG dose deviation larger than 3 Gy. The patient selection method was validated in a second patient cohort of 43 patients.

Results

After multivariable analysis, the planned PG Dmean remained the only significant parameter for PG ΔDmean. A sensitivity of 91% and 80% could be obtained using a threshold of PG Dmean of 22.2 Gy, for the development and validation cohorts, respectively. This would spare 38% (development cohort) and 24% (validation cohort) of patients from the labour-intensive ART procedure.

Conclusions

The presented method to select patients for ART pre-treatment reduces the labour of ART, contributing to a more effective allocation of the department resources.