Quality of life and toxicity guided treatment plan optimisation for head and neck cancer
| Autor: | Erik W Korevaar, Roel J H M Steenbakkers, Arjen van der Schaaf, Johannes A. Langendijk, Stefan Both, Hans Paul van der Laan, Lisa Van den Bosch |
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| Přispěvatelé: | Guided Treatment in Optimal Selected Cancer Patients (GUTS), Damage and Repair in Cancer Development and Cancer Treatment (DARE), Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE) |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
NCRI medicine.medical_treatment MODELS NTCP digestive system Quality of life Treatment plan Humans Medicine Radiology Nuclear Medicine and imaging Head and neck cancer RISK business.industry Radiotherapy Planning Computer-Assisted Dose optimisation Radiotherapy Dosage Hematology medicine.disease Dysphagia DELINEATION Radiation therapy NCIC CTG EORTC Oncology Head and Neck Neoplasms Speech problems Toxicity Toxicities HKNPCSG DAHANCA Quality of Life Radiotherapy Intensity-Modulated Radiology medicine.symptom business Complication RADIOTHERAPY |
| Zdroj: | Radiotherapy and Oncology, 162, 85-90. ELSEVIER IRELAND LTD |
| ISSN: | 0167-8140 |
| DOI: | 10.1016/j.radonc.2021.06.035 |
| Popis: | PURPOSE: To evaluate the feasibility of semi-automatic Quality of Life (QOL)-weighted normal tissue complication probability (NTCP)-guided VMAT treatment plan optimisation in head and neck cancer (HNC) and compare predicted QOL to that obtained with conventional treatment.MATERIALS AND METHODS: This study included 30 HNC patients who were treated with definitive radiotherapy. QOL-weighted NTCP-guided VMAT plans were optimised directly on 80 multivariable NTCP models of 20 common toxicities and symptoms on 4 different time points (6, 12, 18 and 24 months after radiotherapy) and each NTCP model was weighted relative to its impact on QOL. Planning results, NTCP and predicted QOL were compared with the clinical conventional VMAT plans.RESULTS: QOL-weighted NTCP-guided VMAT plans were clinically acceptable, had target coverage equally adequate as the clinical plans, but prioritised sparing of organs at risk (OAR) related to toxicities and symptoms that had the highest impact on QOL. NTCP was reduced for, e.g., dysphagia (-6.1% for ≥ grade 2/ -7.6% for ≥ grade 3) and moderate-to-severe fatigue / speech problems / hoarseness (-0.7%/ -1.5%/ -2.5%) at 6 months, respectively. Concurrently, the average NTCP of toxicities related to salivary function increased with +0.4% to +5.7%. QOL-weighted NTCP-guided plans were produced in less time, were less dependent on the treatment planner experience and yielded more consistent results. The average predicted QOL improved by 0.7, 0.9, 1.0, and 1.1 points on a 0-100 scale (p < 0.001) at 6, 12, 18, and 24 months, respectively, compared to the clinical plans.CONCLUSION: Semi-automatic QOL-weighted NTCP-guided VMAT treatment plan optimisation is feasible. It prioritised sparing of OARs related to high-impact toxicities and symptoms and resulted in a systematic improvement of predicted QOL compared to conventional VMAT. |
| Databáze: | OpenAIRE |
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