The Importance of Verification CT-QA Scans in Patients Treated with IMPT for Head and Neck Cancers
| Autor: | Riley H Harper, Krishan R. Jethwa, Noelle C Deiter, Lisa A. McGee, Chris Beltran, Jean-Claude M. Rwigema, Nadia N. Laack, M. Petersen, David M. Routman, Samir H. Patel, Michelle A. Neben-Wittich, Jaden D. Evans, William S. Harmsen, Robert L. Foote, Heather Schultz, Scott C. Lester, Yolanda I. Garces, Daniel J. Ma, Daniel W. Mundy, Aman Anand, Ashley Hunzeker |
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| Rok vydání: | 2020 |
| Předmět: |
lcsh:Medical physics. Medical radiology. Nuclear medicine
lcsh:R895-920 Logistic regression 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine proton therapy Medicine lcsh:Nuclear and particle physics. Atomic energy. Radioactivity Radiology Nuclear Medicine and imaging In patient Head and neck business.industry Proportional hazards model Head and neck cancer Weight change Hazard ratio Original Articles Odds ratio medicine.disease Atomic and Molecular Physics and Optics ct verification impt 030220 oncology & carcinogenesis lcsh:QC770-798 head and neck cancer ct quality assurance business Nuclear medicine |
| Zdroj: | International Journal of Particle Therapy, Vol 7, Iss 1, Pp 41-53 (2020) International Journal of Particle Therapy |
| ISSN: | 2331-5180 |
| Popis: | Purpose To understand how verification computed tomography-quality assurance (CT-QA) scans influenced clinical decision-making to replan patients with head and neck cancer and identify predictors for replanning to guide intensity-modulated proton therapy (IMPT) clinical practice. Patients and Methods We performed a quality-improvement study by prospectively collecting data on 160 consecutive patients with head and neck cancer treated using spot-scanning IMPT who underwent weekly verification CT-QA scans. Kaplan-Meier estimates were used to determine the cumulative probability of a replan by week. Predictors for replanning were determined with univariate (UVA) and multivariate (MVA) Cox model hazard ratios (HRs). Logistic regression was used to determine odds ratios (ORs). P Results Of the 160 patients, 79 (49.4%) had verification CT-QA scans, which prompted a replan. The cumulative probability of a replan by week 1 was 13.7% (95% confidence interval [CI], 8.82-18.9), week 2, 25.0% (95% CI, 18.0-31.4), week 3, 33.1% (95% CI, 25.4-40.0), week 4, 45.6% (95% CI, 37.3-52.8), and week 5 and 6, 49.4% (95% CI, 41.0-56.6). Predictors for replanning were sinonasal disease site (UVA: HR, 1.82, P = .04; MVA: HR, 3.64, P = .03), advanced stage disease (UVA: HR, 4.68, P 60 Gy equivalent (GyE; relative biologic effectiveness, 1.1) (UVA: HR, 1.99, P Conclusions Weekly verification CT-QA scans frequently influenced clinical decision-making to replan. Additional studies that evaluate the practice of monitoring IMPT-treated patients with weekly CT-QA scans and whether that improves clinical outcomes are warranted. |
| Databáze: | OpenAIRE |
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