Analysis of skin dose distribution for the prediction of severe radiation dermatitis in head and neck squamous cell carcinoma patients treated with concurrent chemo-radiotherapy.
Carcinoma, Squamous Cell
/ drug therapy
Cetuximab
/ adverse effects
Chemoradiotherapy
/ adverse effects
Cisplatin
/ adverse effects
Head and Neck Neoplasms
/ therapy
Humans
Radiodermatitis
/ diagnosis
Radiotherapy, Intensity-Modulated
/ adverse effects
Squamous Cell Carcinoma of Head and Neck
/ therapy
head and neck cancer
intensity-modulated radiotherapy
predictive factors
radiation dermatitis
squamous cell carcinoma
Journal
Head & neck
ISSN: 1097-0347
Titre abrégé: Head Neck
Pays: United States
ID NLM: 8902541
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
14
05
2019
revised:
16
09
2019
accepted:
09
10
2019
pubmed:
5
11
2019
medline:
22
6
2021
entrez:
5
11
2019
Statut:
ppublish
Résumé
We investigated whether the pattern of intensity-modulated radiotherapy (IMRT) dose distribution to the skin can be correlated with the development of G3/G4 radiation dermatitis (RD). A frequency-matched cohort analysis was perfomed on patients treated with IMRT and concurrent cisplatin or cetuximab. Risk ratios were obtained by fitting Poisson regression models. The incidence of G3/G4 RD was 41.1% in 90 patients included (50% vs 36.6% in the cetuximab and cisplatin cohorts, respectively). In multivariate analysis, PS ≥ 1 and weight loss at RT completion >10 kg were the only factors that retained significance. The best dosimetric predictive accuracy was provided by 19.9 cc and 5.8 cc of skin ring 2 mm V50 and V60, respectively (AUC: 0.61 for both). Along with clinical factors, the pattern of dose distribution to a ring structure localized 2 mm below the patient's surface may help predict the development of severe RD.
Sections du résumé
BACKGROUND
We investigated whether the pattern of intensity-modulated radiotherapy (IMRT) dose distribution to the skin can be correlated with the development of G3/G4 radiation dermatitis (RD).
METHODS
A frequency-matched cohort analysis was perfomed on patients treated with IMRT and concurrent cisplatin or cetuximab. Risk ratios were obtained by fitting Poisson regression models.
RESULTS
The incidence of G3/G4 RD was 41.1% in 90 patients included (50% vs 36.6% in the cetuximab and cisplatin cohorts, respectively). In multivariate analysis, PS ≥ 1 and weight loss at RT completion >10 kg were the only factors that retained significance. The best dosimetric predictive accuracy was provided by 19.9 cc and 5.8 cc of skin ring 2 mm V50 and V60, respectively (AUC: 0.61 for both).
CONCLUSION
Along with clinical factors, the pattern of dose distribution to a ring structure localized 2 mm below the patient's surface may help predict the development of severe RD.
Substances chimiques
Cetuximab
PQX0D8J21J
Cisplatin
Q20Q21Q62J
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
244-253Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2019 Wiley Periodicals, Inc.
Références
Hymes S, Strom E, Fife C. Radiation dermatitis: clinical presentation, pathophysiology, and treatment 2006. J Am Acad Dermatol. 2006;54:28-46.
Lacas B, Bourhis J, Overgaard J, et al. Role of radiotherapy fractionation in head and neck cancers (MARCH): an updated meta-analysis. Lancet Oncol. 2017;18:1221-1237.
Pignon JP, Le Maitre A, Maillard E, et al. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol. 2009;92:4-14.
Bonner JA, Harari PM, Giralt J, et al. Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Engl J Med. 2006;354:567-578.
Bentzen SM, Trotti AM. Evaluation of early and late toxicities in chemoradiation trials. J Clin Oncol. 2007;25:4096-4103.
Nutting CM, Morden JP, Harrington KJ, et al. Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial. Lancet Oncol. 2011;12:127-136.
Lee N, Chuang C, Quivey JM, et al. Skin toxicity due to intensity-modulated radiotherapy for head-and-neck carcinoma. Int J Radiat Oncol Biol Phys. 2002;53:630-637.
Brodin NP, Tomè WA. Revisiting the dose constraints for head and neck OARs in the current era of IMRT. Oral Oncol. 2018;86:8-18.
Mascia F, Cataisson C, Lee TC, et al. EGFR regulates the expression of keratinocyte-derived granulocyte/macrophage colony-stimulating factor in vitro and in vivo. J Invest Dermatol. 2010;130:682-693.
Studer G, Brown M, Salgueiro EB, et al. Grade 3/4 dermatitis in head and neck cancer patients treated with concurrent cetuximab and IMRT. Int J Radiat Oncol Biol Phys. 2011;81:110-117.
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373-383.
NCCN guidelines. Head and Neck Cancers, version 2.2018. http://www.nccn.org.
Ahn MJ, D'Cruz A, Vermorken JB, et al. Clinical recommendations for defining platinum unsuitable head and neck cancer patient populations on chemoradiotherapy: a literature review. Oral Oncol. 2016;53:10-16.
Bonomo P, Desideri I, Loi M, et al. Management of severe bio-radiation dermatitis induced by radiotherapy and cetuximab in patients with head and neck cancer: emphasizing the role of calcium alginate dressings. Support Care Cancer. 2019;27:2957-2967.
Gregoire V, Evans M, Le QT, et al. Delineation of the primary tumour clinical target volumes (CTV-P) in laryngeal, hypopharyngeal, oropharyngeal and oral cavity squamous cell carcinoma: AIRO, CACA, DAHANCA, EORTC, GEORCC, GORTEC, HKNPCSG, HNCIG, IAG-KHT, LPRHHT, NCIC CTG, NCRI, NRG oncology, PHNS, SBRT, SOMERA, SRO, SSHNO, TROG consensus guidelines. Radiother Oncol. 2018;126:3-24.
National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE), version 4.0. 2009 May. http://evs.nci.nih/gov.
Vermorken JB, Remenar E, Van Herpen C, et al. Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer. N Engl J Med. 2007;357:1695-1704.
Gregoire V, Langendijk JA, Nuyts S. Advances in radiotherapy for head and neck cancer. J Clin Oncol. 2015;33:3277-3284.
Rosenthal DI, Chambers MS, Fuller CD, et al. Beam path toxicities to non-target structures during intensity-modulated radiation therapy for head and neck cancer. Int J Radiat Oncol Biol Phys. 2008;72:747-755.
Price RA Jr, Koren S, Veltchev I, et al. Planning target volume-to-skin proximity for head-and-neck intensity modulated radiation therapy treatment planning. Pract Radiat Oncol. 2014;3:e21-e29.
Penoncello GP, Ding GX. Skin dose differences between intensity-modulated radiation therapy and volumetric-modulated arc therapy and between boost and integrated treatment regimens for treating head and neck and other cancer sites in patients. Med Dosim. 2016;41:80-86.
Bentzen SM, Constine LS, Deasy JO, et al. Quantitative analyses of normal tissue effects in the clinic (QUANTEC): an introductionto the scientific issues. Int J Radiat Oncol Biol Phys. 2010;76:S3-S9.
Brouwer CL, Steenbakkers RJ, Langendijk JA, et al. Identifying patients who may benefit from adaptive radiotherapy: does the literature on anatomic and dosimetric changes in head and neck organs at risk during radiotherapy provide information to help? Radiother Oncol. 2015;115:285-294.
Heukelom J, Fuller CD. Head and neck cancer adaptive radiation therapy (ART): conceptual considerations for the informed clinician. Semin Radiat Oncol. 2019;29:258-273.
Capelle L, Mackenzie M, Field C, Parliament M, Ghosh S, Scrimger R. Adaptive radiotherapy using helical tomotherapy for head and neck cancer in definitive and postoperative settings: initial results. Clin Oncol (R Coll Radiol). 2012;24:208-215.
Bøje CR, Dalton SO, Primdahl H, et al. Evaluation of comorbidity in 9388 head and neck cancer patients: a national cohort study from the DAHANCA database. Radiother Oncol. 2014;110:91-97.
Mori M, Cattaneo GM, Dell'Oca I, et al. Skin DVHs predict cutaenous toxicity in head and neck cancer patients treated with tomotherapy. Phys Med. 2019;59:133-141.
Lacouture ME. Mechanisms of cutaneous toxicities to EGFR inhibitors. Nat Rev Cancer. 2006;6:803-812.
Emami B, Lyman J, Brown A, et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys. 1991;21:109-122.
Bonomo P, Loi M, Desideri I, et al. Incidence of skin toxicity in squamous cell carcinoma of the head and neck treated with radiotherapy and cetuximab: a systematic review. Crit Rev Oncol Hematol. 2017;120:98-110.
Karam SD, Reddy K, Blatchford PJ, et al. Final report of a phase I trial of olaparib with cetuximab and radiation for heavy smoker patients with locally advanced head and neck cancer. Clin Cancer Res. 2018;24:4949-4959.
NCT03040999. www.clinicaltrials.gov.