Analysis of skin dose distribution for the prediction of severe radiation dermatitis in head and neck squamous cell carcinoma patients treated with concurrent chemo-radiotherapy
Analysis of skin dose distribution for the prediction of severe radiation dermatitis in head and neck squamous cell carcinoma patients treated with concurrent chemo-radiotherapy
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DOI：
10.1002/hed.25997
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发表时间：
2019-11-04
影响因子：
2.9
通讯作者：
Caini, Saverio
中科院分区：
文献类型：
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作者：
Bonomo, Pierluigi;Talamonti, Cinzia;Caini, Saverio
背景：我们研究了调强放射治疗(IMRT)对皮肤的剂量分布模式是否与G3/G4放射性皮炎(RD)的发生有关。方法对接受调强放疗联合顺铂或西妥昔单抗治疗的患者进行频率匹配队列分析。风险比由Poisson回归模型拟合得到。结果90例患者中G3/G4 RD的发生率为41.1%(西妥昔单抗组和顺铂组分别为50%和36.6%)。在多变量分析中，PS>；=1和完成RT时体重减轻10 kg是唯一具有统计学意义的因素。皮环2 mm V50和V60的剂量预测准确率分别为19.9cc和5.8cc(AUC：0.61)。结论结合临床因素，位于患者体表下方2 mm处的环形结构的剂量分布模式可能有助于预测严重RD的发展。
Background We investigated whether the pattern of intensity-modulated radiotherapy (IMRT) dose distribution to the skin can be correlated with the development of G3/G4 radiation dermatitis (RD). Methods A frequency-matched cohort analysis was perfomed on patients treated with IMRT and concurrent cisplatin or cetuximab. Risk ratios were obtained by fitting Poisson regression models. Results The incidence of G3/G4 RD was 41.1% in 90 patients included (50% vs 36.6% in the cetuximab and cisplatin cohorts, respectively). In multivariate analysis, PS >= 1 and weight loss at RT completion >10 kg were the only factors that retained significance. The best dosimetric predictive accuracy was provided by 19.9 cc and 5.8 cc of skin ring 2 mm V50 and V60, respectively (AUC: 0.61 for both). Conclusion Along with clinical factors, the pattern of dose distribution to a ring structure localized 2 mm below the patient's surface may help predict the development of severe RD.