Miranda E M C Christianen1, Arjen van der Schaaf1, Hans Paul van der Laan1, Irma M Verdonck-de Leeuw2, Patricia Doornaert3, Olga Chouvalova1, Roel J H M Steenbakkers1, Charles René Leemans2, Sjoukje F Oosting4, Bernard F A M van der Laan5, Jan L N Roodenburg6, Ben J Slotman3, Hendrik P Bijl1, Johannes A Langendijk7. 1. Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands. 2. Department of Otorhinolaryngology-Head and Neck Surgery, VU University Medical Center Amsterdam, The Netherlands. 3. Department of Radiation Oncology, VU University Medical Center Amsterdam, The Netherlands. 4. Department of Medical Oncology, University of Groningen, University Medical Center Groningen, The Netherlands. 5. Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Center Groningen, The Netherlands. 6. Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, The Netherlands. 7. Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands. Electronic address: j.a.langendijk@umcg.nl.
Abstract
PURPOSE: The aim of this study was to clinically validate a multivariable normal tissue complication probability (NTCP) model for grade 2-4 swallowing dysfunction at 6months after radiotherapy or chemoradiation (SWALM6) in head and neck cancer patients treated with swallowing sparing intensity modulated radiotherapy (SW-IMRT) and to test if SW-IMRT resulted in a reduction of the prevalence of SWALM6. MATERIALS AND METHODS: The primary endpoint was SWALM6. For all 186 patients, a standard IMRT (parotid sparing) and a SW-IMRT plan (additional constraints for swallowing organs at risk) was created. The difference in NTCP for SWALM6 (ΔNTCPSWALM6=NTCPstandard-NTCPSW-IMRT) was calculated. Patients were treated with SW-IMRT. The external validation of the NTCP model was analyzed by comparing performance measures. RESULTS: The mean ΔNTCPSWALM6 was 4.9% (range 0.01-17.3%), with a significant lower mean predicted NTCPSW-IMRT of 22.6% (95% CI 20.2-24.9%), compared to NTCPstandard of 27.5% (95% CI 24.9-29.9%) (p<0.001). There was a perfect correspondence of NTCPSW-IMRT with the observed prevalence of SWALM6 (22.6%). The overall model performance, discrimination and 'goodness of fit' were good. CONCLUSION: We externally validated the multivariable NTCP model for SWALM6 in SW-IMRT treated patients, showing reduced swallowing dysfunction by reducing the dose parameters included in this NTCP model.
PURPOSE: The aim of this study was to clinically validate a multivariable normal tissue complication probability (NTCP) model for grade 2-4 swallowing dysfunction at 6months after radiotherapy or chemoradiation (SWALM6) in head and neck cancerpatients treated with swallowing sparing intensity modulated radiotherapy (SW-IMRT) and to test if SW-IMRT resulted in a reduction of the prevalence of SWALM6. MATERIALS AND METHODS: The primary endpoint was SWALM6. For all 186 patients, a standard IMRT (parotid sparing) and a SW-IMRT plan (additional constraints for swallowing organs at risk) was created. The difference in NTCP for SWALM6 (ΔNTCPSWALM6=NTCPstandard-NTCPSW-IMRT) was calculated. Patients were treated with SW-IMRT. The external validation of the NTCP model was analyzed by comparing performance measures. RESULTS: The mean ΔNTCPSWALM6 was 4.9% (range 0.01-17.3%), with a significant lower mean predicted NTCPSW-IMRT of 22.6% (95% CI 20.2-24.9%), compared to NTCPstandard of 27.5% (95% CI 24.9-29.9%) (p<0.001). There was a perfect correspondence of NTCPSW-IMRT with the observed prevalence of SWALM6 (22.6%). The overall model performance, discrimination and 'goodness of fit' were good. CONCLUSION: We externally validated the multivariable NTCP model for SWALM6 in SW-IMRT treated patients, showing reduced swallowing dysfunction by reducing the dose parameters included in this NTCP model.
Authors: Molly K Barnhart; Bena Cartmill; Elizabeth C Ward; Elizabeth Brown; Jonathon Sim; George Saade; Sandra Rayner; Rachelle A Robinson; Virginia A Simms; Robert I Smee Journal: Dysphagia Date: 2019-02-11 Impact factor: 3.438
Authors: Primož Strojan; Katherine A Hutcheson; Avraham Eisbruch; Jonathan J Beitler; Johannes A Langendijk; Anne W M Lee; June Corry; William M Mendenhall; Robert Smee; Alessandra Rinaldo; Alfio Ferlito Journal: Cancer Treat Rev Date: 2017-07-18 Impact factor: 12.111
Authors: Mischa de Ridder; Cornelis P J Raaijmakers; Frank A Pameijer; Remco de Bree; Floris C J Reinders; Patricia A H Doornaert; Chris H J Terhaard; Marielle E P Philippens Journal: Cancers (Basel) Date: 2022-06-20 Impact factor: 6.575
Authors: Beth M Beadle; Kai-Ping Liao; Sharon H Giordano; Adam S Garden; Katherine A Hutcheson; Stephen Y Lai; B Ashleigh Guadagnolo Journal: Cancer Date: 2016-09-23 Impact factor: 6.860
Authors: D Alterio; M A Gerardi; L Cella; R Spoto; V Zurlo; A Sabbatini; C Fodor; V D'Avino; M Conson; F Valoriani; D Ciardo; R Pacelli; A Ferrari; P Maisonneuve; L Preda; R Bruschini; M Cossu Rocca; E Rondi; S Colangione; G Palma; S Dicuonzo; R Orecchia; G Sanguineti; B A Jereczek-Fossa Journal: Strahlenther Onkol Date: 2017-09-07 Impact factor: 3.621
Authors: Imran Petkar; Keith Rooney; Justin W G Roe; Joanne M Patterson; David Bernstein; Justine M Tyler; Marie A Emson; James P Morden; Kathrin Mertens; Elizabeth Miles; Matthew Beasley; Tom Roques; Shreerang A Bhide; Kate L Newbold; Kevin J Harrington; Emma Hall; Christopher M Nutting Journal: BMC Cancer Date: 2016-10-06 Impact factor: 4.430