Beam path toxicity in candidate organs-at-risk: assessment of radiation emetogenesis for patients receiving head and neck intensity modulated radiotherapy.

Abstract

BACKGROUND:

To investigate potential dose-response relationship between radiation-associated nausea and vomiting (RANV) reported during radiotherapy and candidate nausea/vomiting-associated regions of interest (CNV-ROIs) in head and neck (HNC) squamous cell carcinomas.

METHODS AND MATERIAL:

A total of 130 patients treated with IMRT with squamous cell carcinomas of head and neck were evaluated. For each patient, CNV-ROIs were segmented manually on planning CT images. Clinical on-treatment RANV data were reconstructed by a review of the records for all patients. Dosimetric data parameters were recorded from dose-volume histograms. Nausea and vomiting reports were concatenated as a single binary "Any N/V" variable, and as a "CTC-V2+" variable.

RESULTS:

The mean dose to CNV-ROIs was higher for patients experiencing RANV events. For patients receiving IMRT alone, a dose-response effect was observed with varying degrees of magnitude, at a statistically significant level for the area postrema, brainstem, dorsal vagal complex, medulla oblongata, solitary nucleus, oropharyngeal mucosa and whole brain CNV-ROIs.

CONCLUSION:

RANV is a common therapy-related morbidity facing patients receiving HNC radiotherapy, and, for those receiving radiotherapy-alone, is associated with modifiable dose to specific CNS structures.

• Authors: Esengul Kocak-Uzel, G Brandon Gunn, Rivka R Colen, Micheal E Kantor, Abdallah S R Mohamed, Sara Schoultz-Henley, Paniyotis Mavroidis, Steven J Frank, Adam S Garden, Beth M Beadle, William H Morrison, Jack Phan, David I Rosenthal, Clifton D Fuller
• Journal: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology (Radiother Oncol) Vol. 111 Issue 2 Pg. 281-8 (May 2014) ISSN: 1879-0887 [Electronic] Ireland
• PMID: 24746582 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Brain (radiation effects)
• Carcinoma, Squamous Cell (radiotherapy)
• Dose-Response Relationship, Radiation
• Female
• Head and Neck Neoplasms (radiotherapy)
• Humans
• Logistic Models
• Male
• Middle Aged
• Nausea (etiology)
• Organs at Risk (radiation effects)
• Prospective Studies
• Radiotherapy, Intensity-Modulated (adverse effects)
• Squamous Cell Carcinoma of Head and Neck
• Vomiting (etiology)