Predictors of toxicity after curative reirradiation with intensity modulated radiotherapy or proton therapy for recurrent head and neck carcinoma: new dose constraints for pharyngeal constrictors muscles and oral cavity.
Strahlenther Onkol
; 199(10): 901-909, 2023 10.
Article
em En
| MEDLINE
| ID: mdl-37256301
ABSTRACT
BACKGROUND:
Our study aims to identify predictive factors of moderate to severe (grade ≥â¯2) late toxicity after reirradiation (reRT) of recurrent head and neck carcinoma (HNC) and explore the correlations between dose organs at risk (OAR) and grade ≥â¯2 toxicity. MATERIAL ANDMETHODS:
Between 09/2007 and 09/2019, 55 patients were re-irradiated with IMRT or proton therapy with curative intent for advanced HNC. Our study included all patients for whom data from the first and second irradiations were available. Co-variables, including interval to reRT, size of re-irradiated PTV, and dose to OAR, were analyzed as potential predictors for developing moderate to severe long-term toxicity with death as a competing risk. Receiver-operator characteristics (ROC) analysis assessed the association between dose/volume parameters and the risk of toxicity.RESULTS:
Twenty-three patients participated in our study. After a median follow-up of 41 months, 65% of the patients experienced grade ≥â¯2 late toxicity. The average dose to pharyngeal constrictor muscles (PCM) at the time of reRT showed an association with the risk of grade ≥â¯2 dysphagia AUCâ¯= 0.78 (95% CI 0.53-1), optimal cut-off valueâ¯= 36.7â¯Gy (sensitivity 62%/specificity 100%). The average dose to the oral cavity at the time of reRT showed an association with the risk of grade ≥â¯2 dysgeusia AUCâ¯= 0.96 (0.89-1), optimal cut-off valueâ¯= 20.5â¯Gy (sensitivity 100%/specificity 88%).CONCLUSION:
Our analysis depicted an association between the dose to OAR and the risk of developing moderate to severe dysphagia and dysgeusia and proposed new dose constraints for PCM (36.7â¯Gy) and oral cavity (20.5â¯Gy).Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Carcinoma
/
Transtornos de Deglutição
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Radioterapia de Intensidade Modulada
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Terapia com Prótons
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Reirradiação
/
Neoplasias de Cabeça e Pescoço
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article