Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2016
Selection of head and neck cancer patients for adaptive radiotherapy to decrease xerostomia.
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Brouwer Charlotte L, Steenbakkers Roel J H M, van der Schaaf Arjen, Sopacua Chantal T C, van Dijk Lisanne V, Kierkels Roel G J, Bijl Hendrik P, Burgerhof Johannes G M, Langendijk Johannes A, Sijtsema Nanna M
Аннотация
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 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 3Gy. 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 22.2Gy, 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.
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 3Gy. 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 22.2Gy, 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.