Thyroid-optimized and thyroid-sparing radiotherapy in oral cavity and oropharyngeal carcinoma: A dosimetric study.

Autor: Wu AK; Case Western Reserve University School of Medicine, Cleveland, OH, USA., Damico NJ; Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, USA., Healy E; Department of Radiation Oncology, Ohio State University, Columbus, OH, USA., Kharouta MZ; Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, USA., Khandel G; Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, USA., Deshane A; Case Western Reserve University School of Medicine, Cleveland, OH, USA., Sipos J; Department of Endocrinology, Ohio State University, Columbus, OH, USA., Eckstein J; Department of Radiation Oncology, Ohio State University, Columbus, OH, USA., Zoller W; Department of Radiation Oncology, Ohio State University, Columbus, OH, USA., Ewing A; Department of Radiation Oncology, Ohio State University, Columbus, OH, USA., Ling S; Department of Radiation Oncology, Ohio State University, Columbus, OH, USA., Wobb J; Department of Radiation Oncology, Ohio State University, Columbus, OH, USA., Mitchell D; Department of Radiation Oncology, Ohio State University, Columbus, OH, USA., Grecula J; Department of Radiation Oncology, Ohio State University, Columbus, OH, USA., Jhawar S; Department of Radiation Oncology, Ohio State University, Columbus, OH, USA., Miller E; Department of Radiation Oncology, Ohio State University, Columbus, OH, USA., Gamez M; Department of Radiation Oncology, Ohio State University, Columbus, OH, USA., Diavolitsis V; Department of Radiation Oncology, Ohio State University, Columbus, OH, USA., Blakaj D; Department of Radiation Oncology, Ohio State University, Columbus, OH, USA., Bhatt AD; Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, USA.
Jazyk: angličtina
Zdroj: Technical innovations & patient support in radiation oncology [Tech Innov Patient Support Radiat Oncol] 2021 Nov 01; Vol. 20, pp. 28-34. Date of Electronic Publication: 2021 Nov 01 (Print Publication: 2021).
DOI: 10.1016/j.tipsro.2021.10.003
Abstrakt: Background: Radiation-induced hypothyroidism is a common toxicity of head and neck radiation. Our re-planning study aimed to reduce thyroid dose while maintaining target coverage with IMRT.
Methods: We retrospectively identified patients with oral-cavity (n = 5) and oropharyngeal cancer (n = 5). Treatment plans were re-optimized with 45 Gy thyroid mean dose constraint, then we cropped the thyroid out of PTVs and further reduced thyroid dose. Target coverage was delivering 100% dose to ≥ 93% of PTV and 95% of dose to > 99% of PTV.
Results: Originally, average mean dose to thyroid was 5580 cGy. In model I, this dropped to 4325 cGy (p < 0.0001). In model II, average mean dose was reduced to 3154 cGy (p < 0.0001). For PTV low and PTV int, all had acceptable target coverage.
Conclusion: In patients with oral-cavity and oropharyngeal cancers, mean dose could be significantly reduced using a thyroid-optimized or thyroid-sparing IMRT technique with adequate coverage.
Competing Interests: 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.
(© 2021 The Authors.)
Databáze: MEDLINE