Swallowing sparing intensity modulated radiotherapy (SW-IMRT) in head and neck cancer: Clinical validation according to the model-based approach.

Autor: Christianen ME; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands., van der Schaaf A; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands., van der Laan HP; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands., Verdonck-de Leeuw IM; Department of Otorhinolaryngology-Head and Neck Surgery, VU University Medical Center Amsterdam, The Netherlands., Doornaert P; Department of Radiation Oncology, VU University Medical Center Amsterdam, The Netherlands., Chouvalova O; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands., Steenbakkers RJ; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands., Leemans CR; Department of Otorhinolaryngology-Head and Neck Surgery, VU University Medical Center Amsterdam, The Netherlands., Oosting SF; Department of Medical Oncology, University of Groningen, University Medical Center Groningen, The Netherlands., van der Laan BF; Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Center Groningen, The Netherlands., Roodenburg JL; Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, The Netherlands., Slotman BJ; Department of Radiation Oncology, VU University Medical Center Amsterdam, The Netherlands., Bijl HP; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands., Langendijk JA; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands. Electronic address: j.a.langendijk@umcg.nl.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2016 Feb; Vol. 118 (2), pp. 298-303. Date of Electronic Publication: 2015 Dec 14.
DOI: 10.1016/j.radonc.2015.11.009
Abstrakt: Purpose: The aim of this study was to clinically validate a multivariable normal tissue complication probability (NTCP) model for grade 2-4 swallowing dysfunction at 6months after radiotherapy or chemoradiation (SWALM6) in head and neck cancer patients treated with swallowing sparing intensity modulated radiotherapy (SW-IMRT) and to test if SW-IMRT resulted in a reduction of the prevalence of SWALM6.
Materials and Methods: The primary endpoint was SWALM6. For all 186 patients, a standard IMRT (parotid sparing) and a SW-IMRT plan (additional constraints for swallowing organs at risk) was created. The difference in NTCP for SWALM6 (ΔNTCPSWALM6=NTCPstandard-NTCPSW-IMRT) was calculated. Patients were treated with SW-IMRT. The external validation of the NTCP model was analyzed by comparing performance measures.
Results: The mean ΔNTCPSWALM6 was 4.9% (range 0.01-17.3%), with a significant lower mean predicted NTCPSW-IMRT of 22.6% (95% CI 20.2-24.9%), compared to NTCPstandard of 27.5% (95% CI 24.9-29.9%) (p<0.001). There was a perfect correspondence of NTCPSW-IMRT with the observed prevalence of SWALM6 (22.6%). The overall model performance, discrimination and 'goodness of fit' were good.
Conclusion: We externally validated the multivariable NTCP model for SWALM6 in SW-IMRT treated patients, showing reduced swallowing dysfunction by reducing the dose parameters included in this NTCP model.
(Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.)
Databáze: MEDLINE
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