Predictors of toxicity after curative reirradiation with intensity modulated radiotherapy or proton therapy for recurrent head and neck carcinoma: new dose constraints for pharyngeal constrictors muscles and oral cavity.

Humans Radiotherapy, Intensity-Modulated / adverse effects Re-Irradiation / adverse effects Proton Therapy / adverse effects Dysgeusia Deglutition Disorders / etiology Head and Neck Neoplasms / radiotherapy Carcinoma / radiotherapy Mouth Muscles Radiotherapy Dosage Neoplasm Recurrence, Local / radiotherapy
Head and neck carcinoma IMRT Proton therapy Reirradiation Toxicity

Journal

Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]
ISSN: 1439-099X
Titre abrégé: Strahlenther Onkol
Pays: Germany
ID NLM: 8603469

Informations de publication

Date de publication:
10 2023
Historique:
received: 16 12 2022
accepted: 26 03 2023
medline: 23 10 2023
pubmed: 31 5 2023
entrez: 31 5 2023
Statut: ppublish

Résumé

Our study aims to identify predictive factors of moderate to severe (grade ≥ 2) late toxicity after reirradiation (reRT) of recurrent head and neck carcinoma (HNC) and explore the correlations between dose organs at risk (OAR) and grade ≥ 2 toxicity. Between 09/2007 and 09/2019, 55 patients were re-irradiated with IMRT or proton therapy with curative intent for advanced HNC. Our study included all patients for whom data from the first and second irradiations were available. Co-variables, including interval to reRT, size of re-irradiated PTV, and dose to OAR, were analyzed as potential predictors for developing moderate to severe long-term toxicity with death as a competing risk. Receiver-operator characteristics (ROC) analysis assessed the association between dose/volume parameters and the risk of toxicity. Twenty-three patients participated in our study. After a median follow-up of 41 months, 65% of the patients experienced grade ≥ 2 late toxicity. The average dose to pharyngeal constrictor muscles (PCM) at the time of reRT showed an association with the risk of grade ≥ 2 dysphagia: AUC = 0.78 (95% CI: 0.53-1), optimal cut-off value = 36.7 Gy (sensitivity 62%/specificity 100%). The average dose to the oral cavity at the time of reRT showed an association with the risk of grade ≥ 2 dysgeusia: AUC = 0.96 (0.89-1), optimal cut-off value = 20.5 Gy (sensitivity 100%/specificity 88%). Our analysis depicted an association between the dose to OAR and the risk of developing moderate to severe dysphagia and dysgeusia and proposed new dose constraints for PCM (36.7 Gy) and oral cavity (20.5 Gy).

Sections du résumé

BACKGROUND
Our study aims to identify predictive factors of moderate to severe (grade ≥ 2) late toxicity after reirradiation (reRT) of recurrent head and neck carcinoma (HNC) and explore the correlations between dose organs at risk (OAR) and grade ≥ 2 toxicity.
MATERIAL AND METHODS
Between 09/2007 and 09/2019, 55 patients were re-irradiated with IMRT or proton therapy with curative intent for advanced HNC. Our study included all patients for whom data from the first and second irradiations were available. Co-variables, including interval to reRT, size of re-irradiated PTV, and dose to OAR, were analyzed as potential predictors for developing moderate to severe long-term toxicity with death as a competing risk. Receiver-operator characteristics (ROC) analysis assessed the association between dose/volume parameters and the risk of toxicity.
RESULTS
Twenty-three patients participated in our study. After a median follow-up of 41 months, 65% of the patients experienced grade ≥ 2 late toxicity. The average dose to pharyngeal constrictor muscles (PCM) at the time of reRT showed an association with the risk of grade ≥ 2 dysphagia: AUC = 0.78 (95% CI: 0.53-1), optimal cut-off value = 36.7 Gy (sensitivity 62%/specificity 100%). The average dose to the oral cavity at the time of reRT showed an association with the risk of grade ≥ 2 dysgeusia: AUC = 0.96 (0.89-1), optimal cut-off value = 20.5 Gy (sensitivity 100%/specificity 88%).
CONCLUSION
Our analysis depicted an association between the dose to OAR and the risk of developing moderate to severe dysphagia and dysgeusia and proposed new dose constraints for PCM (36.7 Gy) and oral cavity (20.5 Gy).

Identifiants

DOI: 10.1007/s00066-023-02080-y PMID: 37256301
pubmed: 37256301
doi: 10.1007/s00066-023-02080-y
pii: 10.1007/s00066-023-02080-y
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

901-909

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

Références

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Auteurs

Arnaud Beddok (A)

Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue d'Ulm, 75005, Paris/Orsay, France. a.beddok@gmail.com.
Institut Curie, PSL Research University, University Paris Saclay, Inserm LITO, 91898, Orsay, France. a.beddok@gmail.com.
ORCID: 0000-0002-5512-4161

Xavier Maynadier (X)

Biometry Unit, Institut Curie, PSL Research University, Paris, France.

Samar Krhili (S)

Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue d'Ulm, 75005, Paris/Orsay, France.

Catherine Ala Eddine (C)

Department of Radiology, Institut Curie, Paris, France.

Laurence Champion (L)

Institut Curie, PSL Research University, University Paris Saclay, Inserm LITO, 91898, Orsay, France.
Department of Nuclear Medicine, Institut Curie, Saint-Cloud, France.

Anne Chilles (A)

Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue d'Ulm, 75005, Paris/Orsay, France.

Farid Goudjil (F)

Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue d'Ulm, 75005, Paris/Orsay, France.

Sofia Zefkili (S)

Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue d'Ulm, 75005, Paris/Orsay, France.

Malika Amessis (M)

Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue d'Ulm, 75005, Paris/Orsay, France.

Olivier Choussy (O)

Department of Head and Neck Surgery, Institut Curie, Paris, France.

Christophe Le Tourneau (C)

Department of Drug Development and Innovation (D3i), INSERM U900 Research unit, Paris-Saclay University, Institut Curie, Paris, France.

Irene Buvat (I)

Institut Curie, PSL Research University, University Paris Saclay, Inserm LITO, 91898, Orsay, France.

Gilles Créhange (G)

Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue d'Ulm, 75005, Paris/Orsay, France.
Institut Curie, PSL Research University, University Paris Saclay, Inserm LITO, 91898, Orsay, France.

Matthieu Carton (M)

Biometry Unit, Institut Curie, PSL Research University, Paris, France.

Valentin Calugaru (V)

Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue d'Ulm, 75005, Paris/Orsay, France.

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questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Predictors of toxicity after curative...
questionsmedicales.fr › Sciences de l'information › Informatique › Informatique médicale › Applications de l'informatique médicale › Prise de décision assistée par ordinateur › Thérapie assistée par ordinateur › Radiothérapie assistée par ordinateur › Radiothérapie conformationnelle › Radiothérapie conformationnelle avec modulation d'intensité › Predictors of toxicity after curative...
questionsmedicales.fr › Thérapeutique › Reprise du traitement › Réirradiation › Predictors of toxicity after curative...
questionsmedicales.fr › Thérapeutique › Radiothérapie › Radiothérapie par ions lourds › Protonthérapie › Predictors of toxicity after curative...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Troubles sensitifs › Troubles du goût › Dysgueusie › Predictors of toxicity after curative...
questionsmedicales.fr › Maladies oto-rhino-laryngologiques › Maladies du pharynx › Troubles de la déglutition › Predictors of toxicity after curative...
questionsmedicales.fr › Tumeurs › Tumeurs par siège › Tumeurs de la tête et du cou › Predictors of toxicity after curative...
questionsmedicales.fr › Tumeurs › Tumeurs par type histologique › Tumeurs épithéliales épidermoïdes et glandulaires › Carcinomes › Predictors of toxicity after curative...
questionsmedicales.fr › Système stomatognathique › Bouche › Predictors of toxicity after curative...
questionsmedicales.fr › Tissus › Muscles › Predictors of toxicity after curative...
questionsmedicales.fr › Thérapeutique › Radiothérapie › Dosimétrie en radiothérapie › Predictors of toxicity after curative...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Processus néoplasiques › Récidive tumorale locale › Predictors of toxicity after curative...