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Is there a clinical benefit to adaptive planning during tomotherapy in patients with head and neck cancer at risk for xerostomia?

Authors
 You, Sei Hwan  ;  Kim, Song Yi  ;  Lee, Chang Geol  ;  Keum, Ki Chang  ;  Kim, Joo Ho  ;  Lee, Ik Jae  ;  Kim, Yong Bae  ;  Koom, Woong Sub  ;  Cho, Jaeho  ;  Kim, Soo Kon  ;  Kim, Gwi Eon 
Citation
 AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS, Vol.35(3) : 261-266, 2012 
Journal Title
AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS
ISSN
 0277-3732 
Issue Date
2012
MeSH
Adult ; Aged ; Carcinoma, Small Cell/complications ; Carcinoma, Small Cell/pathology ; Carcinoma, Small Cell/radiotherapy ; Carcinoma, Squamous Cell/complications ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/radiotherapy ; Dose-Response Relationship, Radiation ; Female ; Follow-Up Studies ; Head and Neck Neoplasms/complications ; Head and Neck Neoplasms/pathology ; Head and Neck Neoplasms/radiotherapy* ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Parotid Gland/injuries ; Parotid Gland/radiation effects* ; Prognosis ; Radiation Injuries/etiology ; Radiation Injuries/prevention & control* ; Radiotherapy Planning, Computer-Assisted* ; Radiotherapy, Conformal/adverse effects* ; Tomography, X-Ray Computed* ; Xerostomia/etiology ; Xerostomia/prevention & control*
Keywords
Adult ; Aged ; Carcinoma, Small Cell/complications ; Carcinoma, Small Cell/pathology ; Carcinoma, Small Cell/radiotherapy ; Carcinoma, Squamous Cell/complications ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/radiotherapy ; Dose-Response Relationship, Radiation ; Female ; Follow-Up Studies ; Head and Neck Neoplasms/complications ; Head and Neck Neoplasms/pathology ; Head and Neck Neoplasms/radiotherapy* ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Parotid Gland/injuries ; Parotid Gland/radiation effects* ; Prognosis ; Radiation Injuries/etiology ; Radiation Injuries/prevention & control* ; Radiotherapy Planning, Computer-Assisted* ; Radiotherapy, Conformal/adverse effects* ; Tomography, X-Ray Computed* ; Xerostomia/etiology ; Xerostomia/prevention & control*
Abstract
OBJECTIVES: To evaluate the necessity of adaptive planning in helical tomotherapy (TOMO) for head and neck cancer in terms of dosimetric influence on the parotid gland.
METHODS: Thirty-one patients underwent curative TOMO for head and neck cancer from April 2006 to April 2007. For each patient, neck diameter was monitored together with body weight at first cervical spine level through mega-voltage computed tomography during the TOMO course. Ten of 31 patients, with significant weight loss (>5%) and/or neck diameter decrease (>10%), were selected for dosimetric analysis, and parotid dose was recalculated at the fourth and last week of TOMO. Xerostomia was estimated by Radiation Therapy Oncology Group criteria.
RESULTS: The median dose was 69.96 Gy (range, 54 to 69.96 Gy) and there was no grade 3 or greater complication. Ten patients with significant neck diameter decrease and/or weight loss showed frequent grade 2 acute xerostomia (P=0.02). The volume percentage of daily fractional dose over 0.75 Gy for the parotid gland (V0.75 Gy) increased by 23.6% at the end of TOMO.
CONCLUSIONS: For patients with significant anatomic contour change; neck diameter decrease (>10%) or weight loss (>5%), adaptive planning using mega-voltage computed tomography can identify dosimetric changes and reduce deleterious side effects such as xerostomia.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00000421-201206000-00011&LSLINK=80&D=ovft
DOI
21383607
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
Kim, Gwi Eon(김귀언)
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
You, Sei Hwan(유세환)
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89412
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