Patient anatomy-specific trade-offs between sub-clinical disease coverage and normal tissue dose reduction in head-and-neck cancer
| العنوان: | Patient anatomy-specific trade-offs between sub-clinical disease coverage and normal tissue dose reduction in head-and-neck cancer |
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| المؤلفون: | Laura Patricia Kaplan, Anne Ivalu Sander Holm, Jesper Grau Eriksen, Ben J.M. Heijmen, Stine Sofia Korreman, Linda Rossi |
| المساهمون: | Radiotherapy |
| المصدر: | Kaplan, L P, Holm, A I S, Eriksen, J G, Heijmen, B J M, Korreman, S S & Rossi, L 2023, ' Patient anatomy-specific trade-offs between sub-clinical disease coverage and normal tissue dose reduction in head-and-neck cancer ', Radiotherapy and Oncology, vol. 182, 109526 . https://doi.org/10.1016/j.radonc.2023.109526 Radiotherapy and Oncology, 182:109526. Elsevier Ireland Ltd |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | SDG 3 - Good Health and Well-being, Oncology, Head-and-neck squamous cell carcinoma, Multi-criteria optimization, Radiology, Nuclear Medicine and imaging, Patient anatomy-specific target/OAR trade-offs, Hematology, Automated planning |
| الوصف: | Purpose: Risk of subclinical disease decreases with increasing distance from the GTV in head- and-neck squamous cell carcinoma (HNSCC). Depending on individual patient anatomy, OAR sparing could be improved by reducing target coverage in regions with low risk of subclinical spread. Using automated multi-criteria optimization, we investigate patient-specific optimal trade-offs between target periphery coverage and OAR sparing. Methods: VMAT plans for 39 HNSCC patients were retrospectively created following our clinical three-target-level protocol: high-risk (PTV1), intermediate-risk (PTV2, 5 mm expansion from PTV1), and elective (PTV3). A baseline plan fulfilling clinical constraints (D 99 % ≥95 % for all PTVs) was compared to three plans with reduced PTV2 coverage (goals: PTV2 D 99 % ≥90 % or 85 %, or no PTV2) at the outer edge of PTV2. Plans were compared on PTV D 99 %, OAR D mean, and NTCP (xerostomia/dysphagia). Results: Trade-offs between PTV2 coverage and OAR doses varied considerably between patients. For plans with PTV2 D 99 % -goal 90 %, median PTV2 D 99 % was 91.5 % resulting in xerostomia (≥grade 4) and dysphagia (≥grade 2) NTCP decrease of median [maximum] 1.9 % [5.3 %] and 1.1 % [4.1 %], respectively, compared to nominal PTV2 D 99 % -goal 95 %. For PTV2 D 99 % -goal 85 % median PTV D 99 % was 87 % with NTCP improvements of 4.6 % [9.9 %] and 1.5 % [5.4 %]. For no-margin plans, PTV2 D 99 % decreased to 83.3 % with NTCP reductions of 5.1 % [10.2 %] and 1.4 % [6.1 %]. Conclusion: Clinically relevant, patient-specific reductions in OARs and NTCP were observed at limited cost in target under-coverage at the outermost PTV edge. Given the observed inter-patient variations, individual evaluation is warranted to determine whether trade- offs would benefit a specific patient. |
| اللغة: | English |
| تدمد: | 0167-8140 |
| DOI: | 10.1016/j.radonc.2023.109526 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::76df936372a0c77b0d29c15476498987 https://pure.au.dk/portal/da/publications/patient-anatomyspecific-tradeoffs-between-subclinical-disease-coverage-and-normal-tissue-dose-reduction-in-headandneck-cancer(273b6d6d-cab1-4c91-8acf-b7fb62388407).html |
| Rights: | RESTRICTED |
| رقم الانضمام: | edsair.doi.dedup.....76df936372a0c77b0d29c15476498987 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 01678140 |
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| DOI: | 10.1016/j.radonc.2023.109526 |