Esengul Kocak-Uzel1, G Brandon Gunn2, Rivka R Colen3, Micheal E Kantor2, Abdallah S R Mohamed4, Sara Schoultz-Henley5, Paniyotis Mavroidis6, Steven J Frank7, Adam S Garden2, Beth M Beadle2, William H Morrison2, Jack Phan2, David I Rosenthal2, Clifton D Fuller8. 1. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Radiation Oncology, Sisli Etfal Teaching and Research Hospital, Istanbul, Turkey. 2. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA. 3. Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, USA. 4. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Clinical Oncology, University of Alexandria, Egypt. 5. University of Texas Medical School at Houston, USA. 6. Department of Radiation Oncology, The University of Texas Health Science Center at San Antonio, USA. 7. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; The University of Texas Graduate School of Biomedical Sciences, Houston, USA. 8. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; The University of Texas Graduate School of Biomedical Sciences, Houston, USA. Electronic address: cdfuller@mdanderson.org.
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.
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.
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