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Article: Dosimetric predictors of radiation-induced acute nausea and vomiting in IMRT for nasopharyngeal cancer
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TitleDosimetric predictors of radiation-induced acute nausea and vomiting in IMRT for nasopharyngeal cancer
 
AuthorsLee, VHF1
Ng, SCY1
Leung, TW1
Au, GKH1
Kwong, DLW1
 
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
 
CitationInternational Journal of Radiation: Oncology - Biology - Physics, 2012, v. 84 n. 1, p. 176-182 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.ijrobp.2011.10.010
 
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.
 
ISSN0360-3016
2013 Impact Factor: 4.176
 
DOIhttp://dx.doi.org/10.1016/j.ijrobp.2011.10.010
 
ISI Accession Number IDWOS:000308061900052
 
DC FieldValue
dc.contributor.authorLee, VHF
 
dc.contributor.authorNg, SCY
 
dc.contributor.authorLeung, TW
 
dc.contributor.authorAu, GKH
 
dc.contributor.authorKwong, DLW
 
dc.date.accessioned2012-09-20T07:53:12Z
 
dc.date.available2012-09-20T07:53:12Z
 
dc.date.issued2012
 
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.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationInternational Journal of Radiation: Oncology - Biology - Physics, 2012, v. 84 n. 1, p. 176-182 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.ijrobp.2011.10.010
 
dc.identifier.citeulike10234163
 
dc.identifier.doihttp://dx.doi.org/10.1016/j.ijrobp.2011.10.010
 
dc.identifier.epage182
 
dc.identifier.hkuros210079
 
dc.identifier.isiWOS:000308061900052
 
dc.identifier.issn0360-3016
2013 Impact Factor: 4.176
 
dc.identifier.issue1
 
dc.identifier.pmid22245210
 
dc.identifier.scopuseid_2-s2.0-84865699769
 
dc.identifier.spage176
 
dc.identifier.urihttp://hdl.handle.net/10722/163922
 
dc.identifier.volume84
 
dc.languageeng
 
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp
 
dc.publisher.placeUnited States
 
dc.relation.ispartofInternational Journal of Radiation: Oncology - Biology - Physics
 
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 cancer
 
dc.typeArticle
 
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<contributor.author>Ng, SCY</contributor.author>
<contributor.author>Leung, TW</contributor.author>
<contributor.author>Au, GKH</contributor.author>
<contributor.author>Kwong, DLW</contributor.author>
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<description.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&apos; 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&gt;=80% to the VB-T were predictors, using univariate analysis. On multivariate analysis, V40&gt;=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. &#169; 2012 Elsevier Inc. All rights reserved.</description.abstract>
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<subject>Body motions</subject>
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Author Affiliations
  1. The University of Hong Kong