scholarly journals Ototoxicity After Radiotherapy of Head-and-Neck Cancer: The Perils of Retrospective Dose—Response Estimations: In Regard to Bhandare et al. (Int J Radiat Oncol Biol Phys 2007;67:469–479)

2007 ◽  
Vol 68 (5) ◽  
pp. 1582 ◽  
Author(s):  
Charlie Pan ◽  
Avraham Eisbruch
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Dose Response ◽  
Radiat Oncol Biol Phys

Radiation dose response simulation for biomechanical-based deformable image registration of head and neck cancer treatment

2015 ◽  
Vol 60 (21) ◽  
pp. 8481-8489 ◽  
Author(s):  
Adil Al-Mayah ◽  
Joanne Moseley ◽  
Shannon Hunter ◽  
Kristy Brock
Keyword(s):  
Head And Neck Cancer ◽  
Image Registration ◽  
Radiation Dose ◽  
Cancer Treatment ◽  
Head And Neck ◽  
Neck Cancer ◽  
Dose Response ◽  
Deformable Image Registration

Quantitative estimates of the effects of concomitant chemotherapy on acute dysphagia in patients receiving radical treatment for head and neck cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22134-e22134
Author(s):  
S. Bhide ◽  
S. Gulliford ◽  
R. A'Hern ◽  
E. Hall ◽  
K. Newbold ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Radiation Dose ◽  
Head And Neck ◽  
Neck Cancer ◽  
Dose Response ◽  
Concomitant Chemotherapy ◽  
Response Curves ◽  
Pharyngeal Mucosa ◽  
The Mean ◽  
Dose Response Curves

e22134 Purpose: To generate quantitative parameters describing the effect of concomitant chemotherapy on incidence of grade 3 dysphagia (CTCAE v3.0, assisted feeding) using dose response curves in patients receiving radical treatment for head and neck cancer. Methods: Patients treated at a single centre in prospective phase I and II trials of concomitant chemo-IMRT (CRT) (n=85) and the phase III trial of IMRT vs. conventional radiotherapy (PARSPORT) (n=82) formed the basis of this non-randomized comparison. Patients in the PARSPORT trial received radiation alone (RT). Radiation dose for all patients was radiobiologically equivalent to at least 70Gy in 35 fractions. Concomitant chemotherapy was cisplatin (100 mg/m2) on days 1 and 29. G3 dysphagia was recorded prospectively. Dose volume histograms (DVH) were generated for the pharyngeal mucosa. The mean dose (converted to equivalent dose in 2Gy/fraction, MD2) was used as a univariate descriptor of the DVH, for the generation of the dose response curves. A logistic function of the form p=1/[1+(MD50/D)k] was fitted where, p is the probability of the incidence of toxicity, D is the mean dose, MD50 is the mean dose at which 50% of patients experience toxicity and k describes the increase in incidence with increasing dose. The dose response curves were fitted using non-linear logistic regression. Results: The mean MD2 to the pharyngeal mucosa were 56Gy and 55.8Gy respectively, in the CRT and RT groups. There was a statistically significant difference of 25% (95% CI: 10–38, p=0.002) in the incidence of G3 dysphagia between the CRT (68%) and RT (43%) groups. Fitting dose response curves to the clinical data yielded parameter values (95% CIs) of MD50=46 Gy (42–49), k=4.8 (2.3–7.2) for the CRT group and MD50= 58 Gy (55–61), k=3 (1.6-.45) for RT group. Dose response gradients for CRT and RT showed approximately 1.95% and 1.3% increase (respectively) in probability of G3 dysphagia resulting from an increase in mean dose of 1Gy between doses of 30Gy to 70Gy. Conclusions: Addition of concomitant chemotherapy increases the incidence of G3 dysphagia by 0.65% for every 1 Gy increase in radiation dose. The observed MD50 for G3 dysphagia is lower for RT alone (46 Gy vs. 58 Gy). No significant financial relationships to disclose.

Dose–response analysis of acute oral mucositis and pharyngeal dysphagia in patients receiving induction chemotherapy followed by concomitant chemo-IMRT for head and neck cancer

2012 ◽  
Vol 103 (1) ◽  
pp. 88-91 ◽  
Author(s):  
Shreerang A. Bhide ◽  
Sarah Gulliford ◽  
Ulrike Schick ◽  
Aisha Miah ◽  
Shane Zaidi ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Induction Chemotherapy ◽  
Neck Cancer ◽  
Oral Mucositis ◽  
Dose Response ◽  
Response Analysis ◽  
Pharyngeal Dysphagia

scholarly journals Modeling Dose Response for Late Dysphagia in Patients With Head and Neck Cancer in the Modern Era of Definitive Chemoradiation

2017 ◽  
pp. 1-7 ◽  
Author(s):  
Chiaojung Jillian Tsai ◽  
Andrew Jackson ◽  
Jeremy Setton ◽  
Nadeem Riaz ◽  
Sean McBride ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Dose Response ◽  
Muscle Volume ◽  
Constrictor Muscle ◽  
Definitive Chemoradiation ◽  
Disease Site ◽  
The Mean ◽  
Modern Era

Purpose To develop personalized multivariate dose-response models for late dysphagia in patients with head and neck cancer treated in the modern era of combined chemotherapy with intensity-modulated radiation therapy. Patients and Methods The analysis included 424 patients (oropharyngeal cancer [n = 295] and nasopharyngeal, hypopharyngeal, or laryngeal cancer [n = 129]) who received definitive chemoradiation between January 2004 and April 2009. The superior, middle, and inferior pharyngeal constrictor muscles were contoured. We calculated generalized equivalent uniform dose (gEUD) for each and the total constrictor muscle volume, with the volume effect parameter a varying from log10 a = −1 to +1 in steps of 0.1. We used the National Cancer Institute Common Toxicity Criteria for Adverse Events (version 3.0) to grade late dysphagia and logistic regression to evaluate the correlation of gEUD( a) with grade 2 or higher (≥ G2) and grade 3 or higher (≥ G3) late dysphagia at each value of a. Results Median follow-up was 33.3 months (range, 6 to 69 months). There were 41 cases (10%) of ≥ G2 dysphagia and 22 cases (5%) of ≥ G3 dysphagia. Mean doses to the total constrictor ranged from 30.1 to 85.7 Gy (median, 61.2 Gy). The predicted rate of ≥ G2 dysphagia increased by approximately 3.4% per Gy at the mean dose, for which the probability of ≥ G2 dysphagia is 50%. The threshold mean total constrictor doses that limited rates of ≥ G2 and ≥ G3 dysphagia to < 5% were < 58 Gy and < 61 Gy, respectively. Other significant factors in the multivariate predictive model included disease site, mean dose to total constrictor muscle, and patient age. Conclusion Incidences of both ≥ G2 and ≥ G3 dysphagia were dependent on the mean radiation dose to the total constrictor muscle volume, disease site, and patient age. Limiting the total volume of constrictor muscle to < 58 Gy could keep the predicted rate of ≥ G2 dysphagia to < 5%.

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