Deterioration of Intended Target Volume Radiation Dose Due to Anatomical Changes in Patients with Head-and-Neck Cancer
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
Statistical Analysis
3. Results
3.1. Minimum Dose (D99)
3.2. Maximum Dose (D1)
3.3. Clinical Selected Patients for ART
3.4. Reference and Evaluated Volumes
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patient and Treatment Characteristics (n = 188) | |
---|---|
Age (years, (SD)) | 61.1 (10.8) |
Gender (n, (%)) | |
Male | 133 (71) |
Female | 55 (29) |
Weight (kg, (SD)) | 76.3 (17.9) |
BMI at start (kg/m2, (SD)) | 24.9 (5.5) |
Location (n, (%)) | |
Nasopharynx | 31 (16) |
Oroph/oral cavity | 86 (46) |
Larynx/Hypoph | 43 (23) |
Other | 28 (15) |
Pathology (n, (%)) | |
Squamous cell | 174 (93) |
Other | 14 (7) |
HPV | |
No | 64 (34) |
Yes | 47 (25) |
Unknown | 77 (41) |
T stage (n, (%)) * | |
Tx/T1/T2 | 109 (58) |
T3/T4 | 79 (42) |
N stage (n, (%)) * | |
N0 | 66 (35) |
N1-3 | 122 (65) |
N side (n, (%)) | |
Unilateral | 66 (54) |
Bilateral | 56 (46) |
N largest size (cm, (SD)) | 2.3 (1.6) |
N largest size (n, (%)) | |
<3 cm | 82 (67) |
≥3 cm | 40 (33) |
Dahanca (n, (%)) | |
No | 94 (50) |
Yes | 94 (50) |
Concurrent chemotherapy (n, (%)) | |
No | 96 (51) |
Yes | 92 (49) |
PTV margin (n, (%)) | |
5 mm | 90 (48) |
3 mm | 98 (52) |
Tube feeding (n, (%)) | |
No | 124 (66) |
Yes | 64 (34) |
Clinical ART (n, (%)) | |
No | 164 (87) |
Yes | 24 (13) |
Evaluated | Significant | Category | OR | 95% CI | p | AUC | 95% CI |
---|---|---|---|---|---|---|---|
D99_TV1 (15 out of 188 had a threshold violation) | Weight ∆ week 2 | <−2 kg | 0.72 | 0.06–8.36 | 0.796 | ||
−2 to −1 kg | 0.72 | 0.10–5.35 | 0.752 | ||||
−1 to 0 kg | 1.00 | ||||||
>0 kg | 6.46 | 1.27–32.81 | 0.024 | 0.74 | 0.58–0.89 | ||
Weight ∆ week 3 | <−3 kg | 0.73 | 0.06–8.34 | 0.800 | |||
−3 to −1 kg | 3.40 | 0.62–18.30 | 0.158 | ||||
−1 to 0 kg | 1.00 | ||||||
>0 kg | 5.40 | 1.02–28.44 | 0.047 | 0.70 | 0.56–0.84 | ||
Weight ∆ week 4 | <−4 kg | 1.06 | 0.14–7.90 | 0.958 | |||
−4 to −2 kg | 1.54 | 0.24–9.75 | 0.646 | ||||
−2 to 0 kg | 1.00 | ||||||
>0 kg | 3.40 | 0.68–16.87 | 0.138 | ||||
PTV margin | 3 mm | n.a. * | |||||
5 mm | |||||||
D99_TV2 (23 out of 177 had a threshold violation) | Weight | Per kg | 1.03 | 1.01–1.06 | 0.005 | 0.67 | 0.55–0.79 |
BMI | Per kg/m2 | 1.10 | 1.02–1.18 | 0.010 | 0.64 | 0.52–0.76 | |
Weight ∆ week 4 | <−4 kg | 1.50 | 0.43–5.22 | 0.530 | |||
−4 to −2 kg | 1.40 | 0.40–4.88 | 0.597 | ||||
−2 to 0 kg | 1.00 | ||||||
>0 kg | 0.41 | 0.09–1.83 | 0.242 | ||||
PTV margin | 3 mm | 7.40 | 2.11–25.92 | 0.002 | 0.70 | 0.60–0.80 | |
5 mm | 1.00 | ||||||
D1_TV1 (7 out of 188 had a threshold violation) | Age | Per year | 1.06 | 0.98–1.14 | 0.144 | ||
Weight | Per kg | 1.04 | 1.00–1.08 | 0.037 | 0.74 | 0.59–0.89 | |
BMI | Per kg/m2 | 1.11 | 0.99–1.24 | 0.056 | |||
T-category | T1/2 | 1.00 | |||||
T3/4 | 8.88 | 1.05–75.28 | 0.045 | 0.73 | 0.56–0.89 | ||
D1_TV2 (7 out of 177 had a threshold violation) | Age | Per year | 1.06 | 0.98–1.14 | 0.132 | ||
Weight | Per kg | 1.04 | 1.00–1.08 | 0.040 | 0.74 | 0.59–0.89 | |
BMI | Per kg/m2 | 1.11 | 0.99–1.24 | 0.056 | |||
T-category | T1/2 | 1.00 | |||||
T3/4 | 8.78 | 1.03–74.57 | 0.046 | 0.73 | 0.56–0.89 |
Threshold 1 Gy | Dosimetrical Yes | Dosimetrical No | Total |
---|---|---|---|
Clinical Yes | 8 (4%) | 16 (9%) | 24 (13%) |
Clinical No | 28 (15%) | 136 (72%) | 164 (87%) |
Total | 36 (19%) | 152 (81%) | 188 (100%) |
Threshold 2 Gy | |||
Clinical Yes | 4 (2%) | 20 (11%) | 24 (13%) |
Clinical No | 10 (5%) | 154 (82%) | 164 (87%) |
Total | 14 (7%) | 174 (93%) | 188 (100%) |
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Hamming-Vrieze, O.; van Kranen, S.; Walraven, I.; Navran, A.; Al-Mamgani, A.; Tesselaar, M.; van den Brekel, M.; Sonke, J.-J. Deterioration of Intended Target Volume Radiation Dose Due to Anatomical Changes in Patients with Head-and-Neck Cancer. Cancers 2021, 13, 4253. https://doi.org/10.3390/cancers13174253
Hamming-Vrieze O, van Kranen S, Walraven I, Navran A, Al-Mamgani A, Tesselaar M, van den Brekel M, Sonke J-J. Deterioration of Intended Target Volume Radiation Dose Due to Anatomical Changes in Patients with Head-and-Neck Cancer. Cancers. 2021; 13(17):4253. https://doi.org/10.3390/cancers13174253
Chicago/Turabian StyleHamming-Vrieze, Olga, Simon van Kranen, Iris Walraven, Arash Navran, Abrahim Al-Mamgani, Margot Tesselaar, Michiel van den Brekel, and Jan-Jakob Sonke. 2021. "Deterioration of Intended Target Volume Radiation Dose Due to Anatomical Changes in Patients with Head-and-Neck Cancer" Cancers 13, no. 17: 4253. https://doi.org/10.3390/cancers13174253