Planned dose of intensity modulated proton beam therapy versus volumetric modulated arch therapy to tooth-bearing regions.

Autor: Alberga JM; Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: j.m.alberga@umcg.nl., Meijer J; Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Raghoebar GM; Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Langendijk JA; Department of Radiotherapy, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Korfage A; Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Steenbakkers RJHM; Department of Radiotherapy, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Meijer TWH; Department of Radiotherapy, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Reintsema H; Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Vissink A; Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Witjes MJH; Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Jazyk: angličtina
Zdroj: Oral oncology [Oral Oncol] 2023 May; Vol. 140, pp. 106392. Date of Electronic Publication: 2023 Apr 19.
DOI: 10.1016/j.oraloncology.2023.106392
Abstrakt: Background: Intensity modulated proton beam therapy (IMPT) for head and neck cancer offers dosimetric benefits for the organs at risk when compared to photon-based volumetric modulated arch therapy (VMAT). However, limited data exists about the potential benefits of IMPT for tooth-bearing regions. The aim of this study was to compare the IMPT and VMAT radiation dosimetrics of the tooth-bearing regions in head and neck cancer patients. Also, we aimed to identify prognostic factors for a cumulative radiation dose of ≥40 Gy on the tooth-bearing areas, which is considered the threshold dose for prophylactic dental extractions.
Methods: A total of 121 head and neck cancer patients were included in this retrospective analysis of prospectively collected data. We compared the average Dmean values of IMPT versus VMAT of multiple tooth-bearing regions in the same patients. Multivariate logistic regression analysis was performed for receiving a cumulative radiation dose of ≥40 Gy to the tooth-bearing regions (primary endpoint) in both VMAT and IMPT.
Results: A lower Dmean was seen after applying IMPT to the tooth-bearing tumour regions (p < 0.001). Regarding VMAT, oral cavity tumours, T3-T4 tumours, molar regions in the mandible, and regions ipsilateral to the tumour were risk factors for receiving a cumulative radiation dose of ≥40 Gy.
Conclusions: IMPT significantly reduces the radiation dose to the tooth-bearing regions.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The authors declare that they have no conflict of interest. J.A. Langendijk is a member of the IBA Global Advisory Board. An honorarium was paid to the UMCG Research BV. The department of Radiation Oncology received research funding from the IBA.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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