TY - JOUR
T1 - Dose–volume histogram analysis of brainstem necrosis in head and neck tumors treated using carbon-ion radiotherapy
AU - Shirai, Katsuyuki
AU - Fukata, Kyohei
AU - Adachi, Akiko
AU - Saitoh, Jun ichi
AU - Musha, Atsushi
AU - Abe, Takanori
AU - Kanai, Tatsuaki
AU - Kobayashi, Daijiro
AU - Shigeta, Yuka
AU - Yokoo, Satoshi
AU - Chikamatsu, Kazuaki
AU - Ohno, Tatsuya
AU - Nakano, Takashi
N1 - Funding Information:
This work was supported by JSPS KAKENHI (26461878). The funding body had no part in the study’s design; in the collection, analysis and interpretation of the data; in the writing of the manuscript; or in the decision to submit the manuscript for publication.
Publisher Copyright:
© 2017 The Author(s)
PY - 2017/10
Y1 - 2017/10
N2 - Background and purpose: We aimed to evaluate the relationship between brainstem necrosis and dose–volume histograms in patients with head and neck tumors after carbon-ion radiotherapy. Material and methods: We evaluated 85 patients with head and neck tumors who underwent carbon-ion radiotherapy and were followed-up for ≥12 months. Brainstem necrosis was evaluated using the Common Terminology Criteria for Adverse Events (version 4.0). Results: The median follow-up was 24 months, and four patients developed grade 1 brainstem necrosis, with 2-year and 3-year cumulative rates of 2.8% and 6.5%, respectively. Receiver operating characteristic curve analysis revealed the following significant cut-off values: a maximum brainstem dose of 48 Gy (relative biological effectiveness [RBE]), D1 cm3 of 27 Gy (RBE), V40 Gy (RBE) of 0.1 cm3, V30 Gy (RBE) of 0.7 cm3, and V20 Gy (RBE) of 1.4 cm3. Multivariate analysis revealed that V30 Gy (RBE) was most significantly associated with brainstem necrosis. The 2-year cumulative rates were 33% and 0% for V30 Gy (RBE) of ≥0.7 cm3 and <0.7 cm3, respectively (p < 0.001). Conclusions: The present study indicated that the dose constraints might help minimize brainstem necrosis after carbon-ion radiotherapy.
AB - Background and purpose: We aimed to evaluate the relationship between brainstem necrosis and dose–volume histograms in patients with head and neck tumors after carbon-ion radiotherapy. Material and methods: We evaluated 85 patients with head and neck tumors who underwent carbon-ion radiotherapy and were followed-up for ≥12 months. Brainstem necrosis was evaluated using the Common Terminology Criteria for Adverse Events (version 4.0). Results: The median follow-up was 24 months, and four patients developed grade 1 brainstem necrosis, with 2-year and 3-year cumulative rates of 2.8% and 6.5%, respectively. Receiver operating characteristic curve analysis revealed the following significant cut-off values: a maximum brainstem dose of 48 Gy (relative biological effectiveness [RBE]), D1 cm3 of 27 Gy (RBE), V40 Gy (RBE) of 0.1 cm3, V30 Gy (RBE) of 0.7 cm3, and V20 Gy (RBE) of 1.4 cm3. Multivariate analysis revealed that V30 Gy (RBE) was most significantly associated with brainstem necrosis. The 2-year cumulative rates were 33% and 0% for V30 Gy (RBE) of ≥0.7 cm3 and <0.7 cm3, respectively (p < 0.001). Conclusions: The present study indicated that the dose constraints might help minimize brainstem necrosis after carbon-ion radiotherapy.
KW - Brainstem necrosis
KW - Carbon-ion radiotherapy
KW - Dose–volume histogram
KW - Head and neck tumors
KW - Non-squamous cell carcinoma
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U2 - 10.1016/j.radonc.2017.08.014
DO - 10.1016/j.radonc.2017.08.014
M3 - Article
C2 - 28867558
AN - SCOPUS:85028510442
SN - 0167-8140
VL - 125
SP - 36
EP - 40
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 1
ER -