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Article: Dosimetric predictors of radiation-induced acute nausea and vomiting in IMRT for nasopharyngeal cancer

TitleDosimetric predictors of radiation-induced acute nausea and vomiting in IMRT for nasopharyngeal cancer
Authors
KeywordsBody motions
Computed tomography images
Dose-volume histograms
Dosimetric parameter
Dosimetric predictors
Issue Date2012
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp
Citation
International Journal of Radiation: Oncology - Biology - Physics, 2012, v. 84 n. 1, p. 176-182 How to Cite?
Abstract
Purpose: We wanted to investigate dosimetric parameters that would predict radiation-induced acute nausea and vomiting in intensity-modulated radiation therapy (IMRT) for undifferentiated carcinoma of the nasopharynx (NPC). Methods and Materials: Forty-nine consecutive patients with newly diagnosed NPC were treated with IMRT alone in this prospective study. Patients receiving any form of chemotherapy were excluded. The dorsal vagal complex (DVC) as well as the left and right vestibules (VB-L and VB-R, respectively) were contoured on planning computed tomography images. A structure combining both the VB-L and the VB-R, named VB-T, was also generated. All structures were labeled organs at risk (OAR). A 3-mm three-dimensional margin was added to these structures and labeled DVC+3 mm, VB-L+3 mm, VB-R+3 mm, and VB-T+3 mm to account for physiological body motion and setup error. No weightings were given to these structures during optimization in treatment planning. Dosimetric parameters were recorded from dose-volume histograms. Statistical analysis of parameters' association with nausea and vomiting was performed using univariate and multivariate logistic regression. Results: Six patients (12.2%) reported Grade 1 nausea, and 8 patients (16.3%) reported Grade 2 nausea. Also, 4 patients (8.2%) complained of Grade 1 vomiting, and 4 patients (8.2%) experienced Grade 2 vomiting. No patients developed protracted nausea and vomiting after completion of IMRT. For radiation-induced acute nausea, V40 (percentage volume receiving at least 40Gy) to the VB-T and V40>=80% to the VB-T were predictors, using univariate analysis. On multivariate analysis, V40>=80% to the VB-T was the only predictor. There were no predictors of radiation-induced acute vomiting, as the number of events was too small for analysis. Conclusions: This is the first study demonstrating that a V40 to the VB-T is predictive of radiation-induced acute nausea. The vestibules should be labeled as sensitive OARs, and weightings should be considered for dose sparing during optimization in the treatment planning of IMRT. © 2012 Elsevier Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/163922
ISSN
2013 Impact Factor: 4.176
ISI Accession Number ID

 

Author Affiliations
  1. The University of Hong Kong
DC FieldValueLanguage
dc.contributor.authorLee, VHFen_US
dc.contributor.authorNg, SCYen_US
dc.contributor.authorLeung, TWen_US
dc.contributor.authorAu, GKHen_US
dc.contributor.authorKwong, DLWen_US
dc.date.accessioned2012-09-20T07:53:12Z-
dc.date.available2012-09-20T07:53:12Z-
dc.date.issued2012en_US
dc.identifier.citationInternational Journal of Radiation: Oncology - Biology - Physics, 2012, v. 84 n. 1, p. 176-182en_US
dc.identifier.issn0360-3016-
dc.identifier.urihttp://hdl.handle.net/10722/163922-
dc.description.abstractPurpose: We wanted to investigate dosimetric parameters that would predict radiation-induced acute nausea and vomiting in intensity-modulated radiation therapy (IMRT) for undifferentiated carcinoma of the nasopharynx (NPC). Methods and Materials: Forty-nine consecutive patients with newly diagnosed NPC were treated with IMRT alone in this prospective study. Patients receiving any form of chemotherapy were excluded. The dorsal vagal complex (DVC) as well as the left and right vestibules (VB-L and VB-R, respectively) were contoured on planning computed tomography images. A structure combining both the VB-L and the VB-R, named VB-T, was also generated. All structures were labeled organs at risk (OAR). A 3-mm three-dimensional margin was added to these structures and labeled DVC+3 mm, VB-L+3 mm, VB-R+3 mm, and VB-T+3 mm to account for physiological body motion and setup error. No weightings were given to these structures during optimization in treatment planning. Dosimetric parameters were recorded from dose-volume histograms. Statistical analysis of parameters' association with nausea and vomiting was performed using univariate and multivariate logistic regression. Results: Six patients (12.2%) reported Grade 1 nausea, and 8 patients (16.3%) reported Grade 2 nausea. Also, 4 patients (8.2%) complained of Grade 1 vomiting, and 4 patients (8.2%) experienced Grade 2 vomiting. No patients developed protracted nausea and vomiting after completion of IMRT. For radiation-induced acute nausea, V40 (percentage volume receiving at least 40Gy) to the VB-T and V40>=80% to the VB-T were predictors, using univariate analysis. On multivariate analysis, V40>=80% to the VB-T was the only predictor. There were no predictors of radiation-induced acute vomiting, as the number of events was too small for analysis. Conclusions: This is the first study demonstrating that a V40 to the VB-T is predictive of radiation-induced acute nausea. The vestibules should be labeled as sensitive OARs, and weightings should be considered for dose sparing during optimization in the treatment planning of IMRT. © 2012 Elsevier Inc. All rights reserved.-
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobpen_US
dc.relation.ispartofInternational Journal of Radiation: Oncology - Biology - Physicsen_US
dc.subjectBody motions-
dc.subjectComputed tomography images-
dc.subjectDose-volume histograms-
dc.subjectDosimetric parameter-
dc.subjectDosimetric predictors-
dc.titleDosimetric predictors of radiation-induced acute nausea and vomiting in IMRT for nasopharyngeal canceren_US
dc.typeArticleen_US
dc.identifier.emailLee, VHF: vhflee@hku.hken_US
dc.identifier.emailLeung, TW: ltw920@hkucc.hku.hken_US
dc.identifier.emailAu, GKH: hkugkhau@hku.hken_US
dc.identifier.emailKwong, DLW: dlwkwong@hku.hken_US
dc.identifier.authorityLee, VHF=rp00264en_US
dc.identifier.authorityKwong, DLW=rp00414en_US
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.ijrobp.2011.10.010-
dc.identifier.pmid22245210-
dc.identifier.scopuseid_2-s2.0-84865699769-
dc.identifier.hkuros210079en_US
dc.identifier.volume84en_US
dc.identifier.issue1en_US
dc.identifier.spage176en_US
dc.identifier.epage182en_US
dc.identifier.isiWOS:000308061900052-
dc.publisher.placeUnited States-
dc.identifier.citeulike10234163-

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