TY - JOUR
T1 - Selection of head and neck cancer patients for adaptive radiotherapy to decrease xerostomia
AU - Brouwer, Charlotte L.
AU - Steenbakkers, Roel J. H. M.
AU - van der Schaaf, Arjen
AU - Sopacua, Chantal T. C.
AU - van Dijk, Lisanne V.
AU - Kierkels, Roel G. J.
AU - Bijl, Hendrik P.
AU - Burgerhof, Johannes G. M.
AU - Langendijk, Johannes A.
AU - Sijtsema, Nanna M.
N1 - Copyright © 2016 The Author(s). Published by Elsevier Ireland Ltd.. All rights reserved.
PY - 2016/7
Y1 - 2016/7
N2 - Background and purpose: 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 Delta Dmean) 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 Delta Dmean. 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. (C) 2016 The Author(s). Published by Elsevier Ireland Ltd.
AB - Background and purpose: 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 Delta Dmean) 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 Delta Dmean. 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. (C) 2016 The Author(s). Published by Elsevier Ireland Ltd.
KW - Head and neck
KW - Parotid glands
KW - Dosimetric changes
KW - Adaptive radiotherapy
KW - Patient selection
KW - Xerostomia
KW - MODULATED RADIATION-THERAPY
KW - SUBMANDIBULAR-GLANDS
KW - MODEL
KW - IMRT
KW - CARCINOMA
KW - SHRINKAGE
KW - ORGANS
KW - RISK
U2 - 10.1016/j.radonc.2016.05.025
DO - 10.1016/j.radonc.2016.05.025
M3 - Article
C2 - 27345591
SN - 0167-8140
VL - 120
SP - 36
EP - 40
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 1
ER -