Dosimetric advantages of intensity-modulated proton therapy for oropharyngeal cancer compared with intensity-modulated radiation: A case-matched control analysis
Abstract A potential advantage of intensity-modulated proton therapy (IMPT) over intensity-modulated (photon) radiation therapy (IMRT) in the treatment of oropharyngeal carcinoma (OPC) is lower radiation dose to several critical structures involved in the development of nausea and vomiting, mucositi...
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| Veröffentlicht in: | Medical dosimetry : official journal of the American Association of Medical Dosimetrists 2016, Vol.41 (3), p.189-194 |
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| creator | Holliday, Emma B., M.D Kocak-Uzel, Esengul, M.D Feng, Lei, M.S Thaker, Nikhil G., M.D Blanchard, Pierre, M.D., Ph.D Rosenthal, David I., M.D Gunn, G. Brandon, M.D., Ph.D Garden, Adam S., M.D Frank, Steven J., M.D |
| description | Abstract A potential advantage of intensity-modulated proton therapy (IMPT) over intensity-modulated (photon) radiation therapy (IMRT) in the treatment of oropharyngeal carcinoma (OPC) is lower radiation dose to several critical structures involved in the development of nausea and vomiting, mucositis, and dysphagia. The purpose of this study was to quantify doses to critical structures for patients with OPC treated with IMPT and compare those with doses on IMRT plans generated for the same patients and with a matched cohort of patients actually treated with IMRT. In this study, 25 patients newly diagnosed with OPC were treated with IMPT between 2011 and 2012. Comparison IMRT plans were generated for these patients and for additional IMRT-treated controls extracted from a database of patients with OPC treated between 2000 and 2009. Cases were matched based on the following criteria, in order: unilateral vs bilateral therapy, tonsil vs base of tongue primary, T-category, N-category, concurrent chemotherapy, induction chemotherapy, smoking status, sex, and age. Results showed that the mean doses to the anterior and posterior oral cavity, hard palate, larynx, mandible, and esophagus were significantly lower with IMPT than with IMRT comparison plans generated for the same cohort, as were doses to several central nervous system structures involved in the nausea and vomiting response. Similar differences were found when comparing dose to organs at risks (OARs) between the IMPT cohort and the case-matched IMRT cohort. In conclusion, these findings suggest that patients with OPC treated with IMPT may experience fewer and less severe side effects during therapy. This may be the result of decreased beam path toxicities with IMPT due to lower doses to several dysphagia, odynophagia, and nausea and vomiting–associated OARs. Further study is needed to evaluate differences in long-term disease control and chronic toxicity between patients with OPC treated with IMPT in comparison to those treated with IMRT. |
| doi_str_mv | 10.1016/j.meddos.2016.01.002 |
| format | Article |
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Brandon, M.D., Ph.D ; Garden, Adam S., M.D ; Frank, Steven J., M.D</creator><creatorcontrib>Holliday, Emma B., M.D ; Kocak-Uzel, Esengul, M.D ; Feng, Lei, M.S ; Thaker, Nikhil G., M.D ; Blanchard, Pierre, M.D., Ph.D ; Rosenthal, David I., M.D ; Gunn, G. Brandon, M.D., Ph.D ; Garden, Adam S., M.D ; Frank, Steven J., M.D</creatorcontrib><description>Abstract A potential advantage of intensity-modulated proton therapy (IMPT) over intensity-modulated (photon) radiation therapy (IMRT) in the treatment of oropharyngeal carcinoma (OPC) is lower radiation dose to several critical structures involved in the development of nausea and vomiting, mucositis, and dysphagia. The purpose of this study was to quantify doses to critical structures for patients with OPC treated with IMPT and compare those with doses on IMRT plans generated for the same patients and with a matched cohort of patients actually treated with IMRT. In this study, 25 patients newly diagnosed with OPC were treated with IMPT between 2011 and 2012. Comparison IMRT plans were generated for these patients and for additional IMRT-treated controls extracted from a database of patients with OPC treated between 2000 and 2009. Cases were matched based on the following criteria, in order: unilateral vs bilateral therapy, tonsil vs base of tongue primary, T-category, N-category, concurrent chemotherapy, induction chemotherapy, smoking status, sex, and age. Results showed that the mean doses to the anterior and posterior oral cavity, hard palate, larynx, mandible, and esophagus were significantly lower with IMPT than with IMRT comparison plans generated for the same cohort, as were doses to several central nervous system structures involved in the nausea and vomiting response. Similar differences were found when comparing dose to organs at risks (OARs) between the IMPT cohort and the case-matched IMRT cohort. In conclusion, these findings suggest that patients with OPC treated with IMPT may experience fewer and less severe side effects during therapy. This may be the result of decreased beam path toxicities with IMPT due to lower doses to several dysphagia, odynophagia, and nausea and vomiting–associated OARs. Further study is needed to evaluate differences in long-term disease control and chronic toxicity between patients with OPC treated with IMPT in comparison to those treated with IMRT.</description><identifier>ISSN: 0958-3947</identifier><identifier>EISSN: 1873-4022</identifier><identifier>DOI: 10.1016/j.meddos.2016.01.002</identifier><identifier>PMID: 27158021</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute toxicity ; Adult ; Aged ; Aged, 80 and over ; CARCINOMAS ; CENTRAL NERVOUS SYSTEM ; CHEMOTHERAPY ; COMPARATIVE EVALUATIONS ; DIAGNOSIS ; Dosimetric analysis ; ESOPHAGUS ; Female ; HAZARDS ; Hematology, Oncology and Palliative Medicine ; Humans ; IMPT ; JAW ; LARYNX ; LYMPHATIC SYSTEM ; Male ; Middle Aged ; NAUSEA ; Organs at Risk ; Oropharyngeal carcinoma ; Oropharyngeal Neoplasms - radiotherapy ; PATIENTS ; PHARYNX ; PROTON BEAMS ; Proton radiotherapy ; Proton Therapy - adverse effects ; Proton Therapy - methods ; RADIATION DOSES ; RADIATION PROTECTION AND DOSIMETRY ; Radiology ; RADIOLOGY AND NUCLEAR MEDICINE ; Radiometry ; RADIOTHERAPY ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Intensity-Modulated - adverse effects ; Radiotherapy, Intensity-Modulated - methods ; SIDE EFFECTS ; SMOKES ; TONGUE ; TOXICITY ; VOMITING</subject><ispartof>Medical dosimetry : official journal of the American Association of Medical Dosimetrists, 2016, Vol.41 (3), p.189-194</ispartof><rights>American Association of Medical Dosimetrists</rights><rights>2016 American Association of Medical Dosimetrists</rights><rights>Copyright © 2016 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c445t-d5e472769a5fbe1580332d79d562ecd9ecf46586d87cb2728e1df77cff6f3b033</citedby><cites>FETCH-LOGICAL-c445t-d5e472769a5fbe1580332d79d562ecd9ecf46586d87cb2728e1df77cff6f3b033</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0958394716000169$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27158021$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22685145$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Holliday, Emma B., M.D</creatorcontrib><creatorcontrib>Kocak-Uzel, Esengul, M.D</creatorcontrib><creatorcontrib>Feng, Lei, M.S</creatorcontrib><creatorcontrib>Thaker, Nikhil G., M.D</creatorcontrib><creatorcontrib>Blanchard, Pierre, M.D., Ph.D</creatorcontrib><creatorcontrib>Rosenthal, David I., M.D</creatorcontrib><creatorcontrib>Gunn, G. Brandon, M.D., Ph.D</creatorcontrib><creatorcontrib>Garden, Adam S., M.D</creatorcontrib><creatorcontrib>Frank, Steven J., M.D</creatorcontrib><title>Dosimetric advantages of intensity-modulated proton therapy for oropharyngeal cancer compared with intensity-modulated radiation: A case-matched control analysis</title><title>Medical dosimetry : official journal of the American Association of Medical Dosimetrists</title><addtitle>Med Dosim</addtitle><description>Abstract A potential advantage of intensity-modulated proton therapy (IMPT) over intensity-modulated (photon) radiation therapy (IMRT) in the treatment of oropharyngeal carcinoma (OPC) is lower radiation dose to several critical structures involved in the development of nausea and vomiting, mucositis, and dysphagia. The purpose of this study was to quantify doses to critical structures for patients with OPC treated with IMPT and compare those with doses on IMRT plans generated for the same patients and with a matched cohort of patients actually treated with IMRT. In this study, 25 patients newly diagnosed with OPC were treated with IMPT between 2011 and 2012. Comparison IMRT plans were generated for these patients and for additional IMRT-treated controls extracted from a database of patients with OPC treated between 2000 and 2009. Cases were matched based on the following criteria, in order: unilateral vs bilateral therapy, tonsil vs base of tongue primary, T-category, N-category, concurrent chemotherapy, induction chemotherapy, smoking status, sex, and age. Results showed that the mean doses to the anterior and posterior oral cavity, hard palate, larynx, mandible, and esophagus were significantly lower with IMPT than with IMRT comparison plans generated for the same cohort, as were doses to several central nervous system structures involved in the nausea and vomiting response. Similar differences were found when comparing dose to organs at risks (OARs) between the IMPT cohort and the case-matched IMRT cohort. In conclusion, these findings suggest that patients with OPC treated with IMPT may experience fewer and less severe side effects during therapy. This may be the result of decreased beam path toxicities with IMPT due to lower doses to several dysphagia, odynophagia, and nausea and vomiting–associated OARs. Further study is needed to evaluate differences in long-term disease control and chronic toxicity between patients with OPC treated with IMPT in comparison to those treated with IMRT.</description><subject>Acute toxicity</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>CARCINOMAS</subject><subject>CENTRAL NERVOUS SYSTEM</subject><subject>CHEMOTHERAPY</subject><subject>COMPARATIVE EVALUATIONS</subject><subject>DIAGNOSIS</subject><subject>Dosimetric analysis</subject><subject>ESOPHAGUS</subject><subject>Female</subject><subject>HAZARDS</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>IMPT</subject><subject>JAW</subject><subject>LARYNX</subject><subject>LYMPHATIC SYSTEM</subject><subject>Male</subject><subject>Middle Aged</subject><subject>NAUSEA</subject><subject>Organs at Risk</subject><subject>Oropharyngeal carcinoma</subject><subject>Oropharyngeal Neoplasms - radiotherapy</subject><subject>PATIENTS</subject><subject>PHARYNX</subject><subject>PROTON BEAMS</subject><subject>Proton radiotherapy</subject><subject>Proton Therapy - adverse effects</subject><subject>Proton Therapy - methods</subject><subject>RADIATION DOSES</subject><subject>RADIATION PROTECTION AND DOSIMETRY</subject><subject>Radiology</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Radiometry</subject><subject>RADIOTHERAPY</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy Planning, Computer-Assisted</subject><subject>Radiotherapy, Intensity-Modulated - adverse effects</subject><subject>Radiotherapy, Intensity-Modulated - methods</subject><subject>SIDE EFFECTS</subject><subject>SMOKES</subject><subject>TONGUE</subject><subject>TOXICITY</subject><subject>VOMITING</subject><issn>0958-3947</issn><issn>1873-4022</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUk2L1TAUDaI4z9F_IBJw3ZqkTdO6EIbxEwZcqOuQl9xM82yTkuTN0J_jPzWl6kIEV-Fyz7k5556L0HNKakpo9-pUz2BMSDUrVU1oTQh7gA60F03VEsYeogMZeF81Qysu0JOUToQQ3pLmMbpggvKeMHpAP96G5GbI0WmszJ3yWd1CwsFi5zP45PJazcGcJ5XB4CWGHDzOI0S1rNiGiEMMy6ji6m9BTVgrryFiHeZFxUK4d3n856SojFPZBf8aXxVWgmpWWY-lo4PPMUxYeTWtyaWn6JFVU4Jnv95L9O39u6_XH6ubzx8-XV_dVLptea4Mh1Yw0Q2K2yNs9pqGGTEY3jHQZgBt2473nemFPjLBeqDGCqGt7WxzLOBL9HKfG1J2MmmXQY9FjAedJWNdz2nLC6rdUTqGlCJYuUQ3F_-SErnlIk9yz0VuuUhCZcml0F7stOV8LO0_pN9BFMCbHQDF4p2DuCmAskzj4ibABPe_H_4eoCfnnVbTd1ghncI5loUmSWViksgv221sp0G7cha0G5qfYNm6TA</recordid><startdate>2016</startdate><enddate>2016</enddate><creator>Holliday, Emma B., M.D</creator><creator>Kocak-Uzel, Esengul, M.D</creator><creator>Feng, Lei, M.S</creator><creator>Thaker, Nikhil G., M.D</creator><creator>Blanchard, Pierre, M.D., Ph.D</creator><creator>Rosenthal, David I., M.D</creator><creator>Gunn, G. 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Brandon, M.D., Ph.D</au><au>Garden, Adam S., M.D</au><au>Frank, Steven J., M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dosimetric advantages of intensity-modulated proton therapy for oropharyngeal cancer compared with intensity-modulated radiation: A case-matched control analysis</atitle><jtitle>Medical dosimetry : official journal of the American Association of Medical Dosimetrists</jtitle><addtitle>Med Dosim</addtitle><date>2016</date><risdate>2016</risdate><volume>41</volume><issue>3</issue><spage>189</spage><epage>194</epage><pages>189-194</pages><issn>0958-3947</issn><eissn>1873-4022</eissn><abstract>Abstract A potential advantage of intensity-modulated proton therapy (IMPT) over intensity-modulated (photon) radiation therapy (IMRT) in the treatment of oropharyngeal carcinoma (OPC) is lower radiation dose to several critical structures involved in the development of nausea and vomiting, mucositis, and dysphagia. The purpose of this study was to quantify doses to critical structures for patients with OPC treated with IMPT and compare those with doses on IMRT plans generated for the same patients and with a matched cohort of patients actually treated with IMRT. In this study, 25 patients newly diagnosed with OPC were treated with IMPT between 2011 and 2012. Comparison IMRT plans were generated for these patients and for additional IMRT-treated controls extracted from a database of patients with OPC treated between 2000 and 2009. Cases were matched based on the following criteria, in order: unilateral vs bilateral therapy, tonsil vs base of tongue primary, T-category, N-category, concurrent chemotherapy, induction chemotherapy, smoking status, sex, and age. Results showed that the mean doses to the anterior and posterior oral cavity, hard palate, larynx, mandible, and esophagus were significantly lower with IMPT than with IMRT comparison plans generated for the same cohort, as were doses to several central nervous system structures involved in the nausea and vomiting response. Similar differences were found when comparing dose to organs at risks (OARs) between the IMPT cohort and the case-matched IMRT cohort. In conclusion, these findings suggest that patients with OPC treated with IMPT may experience fewer and less severe side effects during therapy. This may be the result of decreased beam path toxicities with IMPT due to lower doses to several dysphagia, odynophagia, and nausea and vomiting–associated OARs. Further study is needed to evaluate differences in long-term disease control and chronic toxicity between patients with OPC treated with IMPT in comparison to those treated with IMRT.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27158021</pmid><doi>10.1016/j.meddos.2016.01.002</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0958-3947 |
| ispartof | Medical dosimetry : official journal of the American Association of Medical Dosimetrists, 2016, Vol.41 (3), p.189-194 |
| issn | 0958-3947 1873-4022 |
| language | eng |
| recordid | cdi_osti_scitechconnect_22685145 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Acute toxicity Adult Aged Aged, 80 and over CARCINOMAS CENTRAL NERVOUS SYSTEM CHEMOTHERAPY COMPARATIVE EVALUATIONS DIAGNOSIS Dosimetric analysis ESOPHAGUS Female HAZARDS Hematology, Oncology and Palliative Medicine Humans IMPT JAW LARYNX LYMPHATIC SYSTEM Male Middle Aged NAUSEA Organs at Risk Oropharyngeal carcinoma Oropharyngeal Neoplasms - radiotherapy PATIENTS PHARYNX PROTON BEAMS Proton radiotherapy Proton Therapy - adverse effects Proton Therapy - methods RADIATION DOSES RADIATION PROTECTION AND DOSIMETRY Radiology RADIOLOGY AND NUCLEAR MEDICINE Radiometry RADIOTHERAPY Radiotherapy Dosage Radiotherapy Planning, Computer-Assisted Radiotherapy, Intensity-Modulated - adverse effects Radiotherapy, Intensity-Modulated - methods SIDE EFFECTS SMOKES TONGUE TOXICITY VOMITING |
| title | Dosimetric advantages of intensity-modulated proton therapy for oropharyngeal cancer compared with intensity-modulated radiation: A case-matched control analysis |
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