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Tytuł:
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Outcomes and patterns of radiation associated brain image changes after proton therapy for head and neck skull base cancers.
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Autorzy:
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Engeseth GM; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, USA; Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Norway; Department of Physics and Technology, University of Bergen, Norway. Electronic address: .
Stieb S; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: .
Mohamed ASR; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: .
He R; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: .
Stokkevåg CH; Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway. Electronic address: .
Brydøy M; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: .
Fuller CD; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: .
Garden AS; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: .
Rosenthal DI; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: .
Phan J; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: .
Morrison WH; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: .
Reddy JP; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: .
Wu R; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: .
Zhang X; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: .
Frank SJ; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: .
Brandon Gunn G; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: .
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Źródło:
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Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2020 Oct; Vol. 151, pp. 119-125. Date of Electronic Publication: 2020 Jul 15.
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Typ publikacji:
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Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.
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Język:
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English
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Imprint Name(s):
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Publication: Limerick : Elsevier Scientific Publishers
Original Publication: Amsterdam : Elsevier Science Publishers, c1983-
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MeSH Terms:
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Head and Neck Neoplasms*/diagnostic imaging
Head and Neck Neoplasms*/radiotherapy
Proton Therapy*/adverse effects
Brain ; Humans ; Radiotherapy Dosage ; Skull Base
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Grant Information:
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P30 CA016672 United States CA NCI NIH HHS; R01 DE025248 United States DE NIDCR NIH HHS; R01 CA214825 United States CA NCI NIH HHS; R25 EB025787 United States EB NIBIB NIH HHS; R56 DE025248 United States DE NIDCR NIH HHS; R01 CA218148 United States CA NCI NIH HHS; R01 CA225190 United States CA NCI NIH HHS; P50 CA097007 United States CA NCI NIH HHS; R01 DE028290 United States DE NIDCR NIH HHS
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Contributed Indexing:
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Keywords: Brain necrosis; Dose–response relationship; Head and neck cancer; MR image change; Radiation Injuries; Skull base, Proton therapy
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Entry Date(s):
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Date Created: 20200718 Date Completed: 20210414 Latest Revision: 20211002
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Update Code:
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20240105
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PubMed Central ID:
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PMC7674217
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DOI:
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10.1016/j.radonc.2020.07.008
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PMID:
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32679304
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Background and Purpose: To characterize patterns and outcomes of brain MR image changes after proton therapy (PT) for skull base head and neck cancer (HNC).
Material and Methods: Post-treatment MRIs ≥6 months were reviewed for radiation-associated image changes (RAIC) in 127 patients. All patients had received at least a point dose of 40 Gy(RBE) to the brain. The MRIs were rigidly registered to planning CTs and RAIC lesions were contoured both on T1 weighted (post-contrast) and T2 weighted sequences, and dose-volume parameters extracted. Probability of RAIC was calculated using multistate survival analysis. Univariate/multivariate analyses were performed using Cox Regression. Recursive partitioning analysis was used to investigate dose-volume correlates of RAIC development.
Results: 17.3% developed RAIC. All RAIC events were asymptomatic and occurred in the temporal lobe (14), frontal lobe (6) and cerebellum (2). The median volume of the contrast enhanced RAIC lesion was 0.5 cc at their maximum size. The RAIC resolved or improved in 45.5% of the patients and were stable or progressed in 36.4%. The 3-year actuarial rate of developing RAIC was 14.3%. RAIC was observed in 63% of patients when V 67 Gy(RBE) of the brain ≥0.17 cc.
Conclusion: Small RAIC lesions after PT occurred in 17.3% of the patients; the majority in nasopharyngeal or sinonasal cancer. The estimated dose-volume correlations confirm the importance of minimizing focal high doses to brain when achievable.
(Copyright © 2020 Elsevier B.V. All rights reserved.)
