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Title: Evaluating the dosimetric effect of treatment-induced changes in virally mediated head and neck cancer patients

Patients with virally mediated head and neck cancer (VMHNC) often present with advanced nodal disease that is highly radioresponsive as demonstrated by tumour and nodal regression during treatment. The resultant changes may impact on the planned dose distribution and so adversely affect the therapeutic ratio. The aim of this study was to evaluate the dosimetric effect of treatment-induced anatomical changes in VMHNC patients who had undergone a replan. Thirteen patients with virally mediated oropharyngeal or nasopharyngeal cancer who presented for definitive radiotherapy between 2005 and 2010 and who had a replan generated were investigated. The dosimetric effect of anatomical changes was quantified by comparing dose–volume histograms (DVH) of primary and nodal gross target volumes and organs at risk (OAR), including spinal cord and parotid glands, from the original plan and a comparison plan. Eleven three-dimensional conformal radiation therapy (3DCRT) and two intensity modulated radiation therapy (IMRT) plans were evaluated. Dose to the spinal cord and brainstem increased by 4.1% and 2.6%, respectively. Mean dose to the parotid glands also increased by 3.5%. In contrast, the dose received by 98% of the primary and nodal gross tumour volumes decreased by 0.15% and 0.3%, respectively, when comparing the initial treatment plan tomore » the comparison plan. In this study, treatment-induced anatomical changes had the greatest impact on OAR dose with negligible effect on the dose to nodal gross tumour volumes. In the era of IMRT, accounting for treatment-induced anatomical changes is important as focus is placed on minimizing the acute and long-term side effects of treatment.« less
Authors:
 [1] ;  [2] ;  [3] ; ;  [4] ;  [1] ;  [2]
  1. Radiation Oncology Department, Princess Alexandra Hospital, Brisbane, Queensland (Australia)
  2. (Australia)
  3. Radiation Oncology Department, Radiation Oncology Mater Centre, Brisbane, Queensland (Australia)
  4. Queensland University of Technology, Brisbane, Queensland (Australia)
Publication Date:
OSTI Identifier:
22402336
Resource Type:
Journal Article
Resource Relation:
Journal Name: Journal of Medical Radiation Sciences (Print); Journal Volume: 60; Journal Issue: 4; Other Information: PMCID: PMC4175821; PMID: 26229622; OAI: oai:pubmedcentral.nih.gov:4175821; Copyright (c) 2013 The Authors. Journal of Medical Radiation Sciences published by Wiley Publishing Asia Pty Ltd on behalf of Australian Institute of Radiography and New Zealand Institute of Medical Radiation Technology; This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
Australia
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; DOSES; GLANDS; HAZARDS; HEAD; NECK; NEOPLASMS; PATIENTS; PLANNING; RADIATION DOSE DISTRIBUTIONS; RADIOTHERAPY; SIDE EFFECTS; SPINAL CORD