Dosimetric parameters predictive of nasolacrimal duct obstruction after carbon-ion radiotherapy for head and neck carcinoma
Dosimetric parameters predictive of nasolacrimal duct obstruction after carbon-ion radiotherapy for head and neck carcinoma
复制标题
DOI：
10.1016/j.radonc.2019.07.022
复制
发表时间：
2019-12-01
影响因子：
5.7
通讯作者：
Nakano, Takashi
中科院分区：
文献类型：
--
作者：
Kubo, Nobuteru;Kubota, Yoshiki;Nakano, Takashi
背景和目的：关于头颈部肿瘤放疗后鼻泪管阻塞的危险因素的信息很少。我们调查的发病率和预测剂量学参数鼻泪管阻塞后，碳离子放射治疗头颈部tumor.Materials和方法：28例头颈部非鳞状细胞癌进行了分析，在这个单机构的前瞻性研究。半数以上的肿瘤位于鼻腔和上颌窦。碳离子放射治疗包括57.6或64.0戈伊（相对生物学有效性; RBE），分16次给药。根据不良事件通用术语标准第4.0版记录鼻泪管阻塞。使用受试者工作特征（ROC）曲线分析确定截止值。VX为X戈伊照射量（RBE）。结果：中位随访时间为60.3个月。1级和2级鼻泪管阻塞的发生率分别为46%（13/28）和7%（2/28）;未记录3级或以上毒性。在整个剂量范围内，阻塞阳性患者的照射鼻泪管体积显著高于阻塞阴性患者（V10、V20、V30、V40、V50和V60的p < 0.001）。在V10 ~ V60范围内，ROC曲线分析确定的截断值对阻塞阳性患者的分类准确率>96%。结论：通过前瞻性队列研究，证实了碳离子放射治疗后鼻泪管阻塞的发生率和预测剂量学参数。这些数据应该有助于优化头颈部肿瘤患者的碳离子放射治疗。(C)2019年，任作家。由爱思唯尔公司出版
Background and purpose: Little information is available on the risk factors for nasolacrimal duct obstruction after radiotherapy for head and neck tumors. We investigated the incidence and predictive dosimetric parameters for nasolacrimal duct obstruction following carbon-ion radiotherapy for head and neck tumors.Materials and methods: Twenty-eight patients with head and neck non-squamous cell carcinoma were analyzed in this single-institution prospective study. More than half of the tumors were located in the nasal cavity and maxillary sinus. Carbon-ion radiotherapy consisting of 57.6 or 64.0 Gy(relative biological effectiveness; RBE) in 16 fractions was administered. Nasolacrimal duct obstruction was recorded according to Common Terminology Criteria for Adverse Events version 4.0. Cutoff values were determined using receiver operating characteristic (ROC) curve analysis. VX indicates the volume irradiated with X Gy (RBE).Results: The median follow-up period was 60.3 months. Incidences of Grade 1 and 2 nasolacrimal duct obstructions were 46% (13/28) and 7% (2/28), respectively; no Grade 3 or greater toxicities were recorded. Throughout the dose range, the volumes of the irradiated nasolacrimal ducts were significantly higher in the obstruction-positive patients than in the obstruction-negative patients (p < 0.001 for V10, V20, V30, V40, V50, and V60). Cutoff values determined by the ROC curve analysis classified the obstruction-positive patients with an accuracy of >96% over the entire range of V10-V60.Conclusion: The incidence and predictive dosimetric parameters for nasolacrimal duct obstruction after carbon-ion radiotherapy were demonstrated in a prospective cohort. These data should help optimize carbon-ion radiotherapy treatments for patients with head and neck tumors. (C) 2019 The Authors. Published by Elsevier B.V.