Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2025
Associations between patient-reported neurocognition, mood, and fatigue and radiation dose in oropharyngeal cancer survivors.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Tyyger Marcus, Iyizoba-Ebozue Zsuzsanna, Nicklin Emma, Boele Florien, Lilley John, Murray Louise, Osorio Eliana Vasquez
Аннотация
BACKGROUND: Radiotherapy is standard of care for oropharyngeal cancer (OPC) but it has been associated with neurocognitive issues, fatigue, and mood disturbances. Voxel-based analysis (VBA) was used to correlate dose and late radiotherapy effects on a fine-grained, voxel-level, without pre-defined regions.
METHOD: A multicentre cross-sectional study, including patients from two tertiary radiotherapy centres: Leeds Cancer Centre (Centre A) and The Christie NHS Foundation Trust, Manchester (Centre B). Patient-reported outcomes for cognitive complaints (Medical Outcomes Study Cognitive Functioning Scale), fatigue (Multidimensional Fatigue Inventory), and mood (Profile of Mood States short form) were administered at least 2 years after treatment. VBA using cross-centre validated software, and three publically available reference CTs, was performed on: single centre only subgroups, and one combined cohort. Regions of significance were clinically reviewed and investigated using dose-volume histogram (DVH) analysis.
RESULTS: 273 patients treated for OPC (Centre A: 118, Centre B: 155) were included, with significant inter-centre differences observed in age, T-stage, N-stage, and dose/fractionation. Dose to the identified cerebellar region differed between centres, with median equivalent dose in 2 Gy fractions (α/β = 3 Gy) of 6.8 Gy for Centre A and 10.2 Gy for Centre B. Correlations of dose with mood disturbance and fatigue within regions of the right-posterior cerebellum were identified for centre B only.
CONCLUSION: There are potential positive associations between right-posterior cerebellum dose with late mood disturbance and fatigue, including potential dose-effect thresholds and cerebella sensitivity to dose per fraction. Further research is needed to clarify these findings, and to establish causality.
METHOD: A multicentre cross-sectional study, including patients from two tertiary radiotherapy centres: Leeds Cancer Centre (Centre A) and The Christie NHS Foundation Trust, Manchester (Centre B). Patient-reported outcomes for cognitive complaints (Medical Outcomes Study Cognitive Functioning Scale), fatigue (Multidimensional Fatigue Inventory), and mood (Profile of Mood States short form) were administered at least 2 years after treatment. VBA using cross-centre validated software, and three publically available reference CTs, was performed on: single centre only subgroups, and one combined cohort. Regions of significance were clinically reviewed and investigated using dose-volume histogram (DVH) analysis.
RESULTS: 273 patients treated for OPC (Centre A: 118, Centre B: 155) were included, with significant inter-centre differences observed in age, T-stage, N-stage, and dose/fractionation. Dose to the identified cerebellar region differed between centres, with median equivalent dose in 2 Gy fractions (α/β = 3 Gy) of 6.8 Gy for Centre A and 10.2 Gy for Centre B. Correlations of dose with mood disturbance and fatigue within regions of the right-posterior cerebellum were identified for centre B only.
CONCLUSION: There are potential positive associations between right-posterior cerebellum dose with late mood disturbance and fatigue, including potential dose-effect thresholds and cerebella sensitivity to dose per fraction. Further research is needed to clarify these findings, and to establish causality.