Dose volume histogram constraints in patients with head and neck cancer treated with surgery and adjuvant HDR brachytherapy: A proposal of the head and neck and skin GEC ESTRO Working group.


Journal

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
ISSN: 1879-0887
Titre abrégé: Radiother Oncol
Pays: Ireland
ID NLM: 8407192

Informations de publication

Date de publication:
01 2021
Historique:
received: 25 03 2020
revised: 05 09 2020
accepted: 08 09 2020
pubmed: 18 9 2020
medline: 24 4 2021
entrez: 17 9 2020
Statut: ppublish

Résumé

The Head and Neck and Skin (HNS) Working group of the GEC-ESTRO acknowledges the lack of widely accepted Dose Volume Histogram (DVH) constraints in adjuvant head and neck brachytherapy and issues recommendations to minimize mandibular Osteoradionecrosis (ORN) and Soft Tissue Necrosis (STN). A total of 227 patients with the diagnosis of head and neck cancer treated with surgery and adjuvant HDR brachytherapy alone or combined with other treatment modalities during the period 2000-2018 were analyzed. STN was observed in 28 out of 227 cases (12.3%) with an average time to appearance of 4.0 months. In previously unirradiated cases, there was a positive correlation between CTV size and STN (p = 0.017) and a trend towards significance between Total EQD2-DVH TV In Unirradiated patients the panel recommends to avoid implantation of postoperative CTVs exceeding 15 cm

Sections du résumé

BACKGROUND
The Head and Neck and Skin (HNS) Working group of the GEC-ESTRO acknowledges the lack of widely accepted Dose Volume Histogram (DVH) constraints in adjuvant head and neck brachytherapy and issues recommendations to minimize mandibular Osteoradionecrosis (ORN) and Soft Tissue Necrosis (STN).
METHODS
A total of 227 patients with the diagnosis of head and neck cancer treated with surgery and adjuvant HDR brachytherapy alone or combined with other treatment modalities during the period 2000-2018 were analyzed.
RESULTS
STN was observed in 28 out of 227 cases (12.3%) with an average time to appearance of 4.0 months. In previously unirradiated cases, there was a positive correlation between CTV size and STN (p = 0.017) and a trend towards significance between Total EQD2-DVH TV
CONCLUSIONS
In Unirradiated patients the panel recommends to avoid implantation of postoperative CTVs exceeding 15 cm

Identifiants

pubmed: 32941955
pii: S0167-8140(20)30787-8
doi: 10.1016/j.radonc.2020.09.015
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

128-134

Informations de copyright

Crown Copyright © 2020. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Alejandro García-Consuegra (A)

Departments of Oncology, University of Navarra, Pamplona, Spain.

Marta Gimeno Morales (M)

Departments of Oncology, University of Navarra, Pamplona, Spain.

Mauricio Cambeiro (M)

Departments of Oncology, University of Navarra, Pamplona, Spain.

Luca Tagliaferri (L)

Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Radiologia, Dipartimento di Diagnostica per Immagini, Roma, Italy.

Gyoergy Kovacs (G)

Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Radiologia, Dipartimento di Diagnostica per Immagini, Roma, Italy.

Erik Van Limbergen (E)

Department of Radiation Oncology, University of Leuven, Belgium.

Luis I Ramos (LI)

Departments of Oncology, University of Navarra, Pamplona, Spain.

José Manuel Arnaiz (J)

Department of Radiation Oncology, Hospital Gregorio Marañón, Madrid, Spain.

Juan Alcalde (J)

Head and Neck Surgery, University of Navarra, Pamplona, Spain.

Fernando Lecanda (F)

Clínica Universidad de Navarra and Department of Solid Tumors and Biomarkers, University of Navarra, Pamplona, Spain.

Rafael Martinez-Monge (R)

Departments of Oncology, University of Navarra, Pamplona, Spain. Electronic address: rmartinezm@unav.es.

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Classifications MeSH