Wencheng Zhang1, Xiaodong Zhang2, Pei Yang3, Pierre Blanchard3, Adam S Garden3, Brandon Gunn3, C David Fuller3, Mark Chambers4, Katherine A Hutcheson4, Rong Ye5, Stephen Y Lai4, Mohamed Abdallah Sherif Radwan6, X Ron Zhu7, Steven J Frank8. 1. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China. 2. Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: xizhang@mdanderson.org. 3. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA. 4. Department of Head & Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA. 5. Department of Quantitative Research, The University of Texas MD Anderson Cancer Center, Houston, USA. 6. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, Egypt. 7. Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, USA. 8. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: sjfrank@mdanderson.org.
Abstract
PURPOSE: We compared mandibular doses and osteoradionecrosis in patients with oropharyngeal cancer after intensity-modulated radiation therapy (IMRT) or intensity-modulated proton therapy (IMPT). METHODS AND MATERIALS: We identified 584 patients who received definitive radiotherapy for oropharyngeal cancer from January 2011 through June 2014 at MD Anderson Cancer Center (534 IMRT and 50 IMPT). The dosimetric variables and osteoradionecrosis were compared with Chi-square test or Fisher's exact test. RESULTS: Median follow-up time for all patients (534 IMRT and IMPT) was 33.8months (33.8months IMRT vs. 34.6months IMPT, P=0.854), and median time to osteoradionecrosis was 11.4months (range 6.74-16.1months). Mandibular doses were lower for patients treated with IMPT (minimum 0.8 vs. 7.3Gy; mean 25.6 vs. 41.2Gy; P<0.001), and osteoradionecrosis rates were lower as well: 2% IMPT (1 grade 1), 7.7% IMRT (12 grade 4, 5 grade 3, 1 grade 2 and 23 grade 1). Osteoradionecrosis location depended on the primary tumor site and high-dose field in the mandible. CONCLUSIONS: Osteoradionecrosis events were significantly associated with higher dose irradiation to mandibular. Use of IMPT minimized excess irradiation of the mandible and consequently reduced the risk of osteoradionecrosis for oropharyngeal cancer.
PURPOSE: We compared mandibular doses and osteoradionecrosis in patients with oropharyngeal cancer after intensity-modulated radiation therapy (IMRT) or intensity-modulated proton therapy (IMPT). METHODS AND MATERIALS: We identified 584 patients who received definitive radiotherapy for oropharyngeal cancer from January 2011 through June 2014 at MD Anderson Cancer Center (534 IMRT and 50 IMPT). The dosimetric variables and osteoradionecrosis were compared with Chi-square test or Fisher's exact test. RESULTS: Median follow-up time for all patients (534 IMRT and IMPT) was 33.8months (33.8months IMRT vs. 34.6months IMPT, P=0.854), and median time to osteoradionecrosis was 11.4months (range 6.74-16.1months). Mandibular doses were lower for patients treated with IMPT (minimum 0.8 vs. 7.3Gy; mean 25.6 vs. 41.2Gy; P<0.001), and osteoradionecrosis rates were lower as well: 2% IMPT (1 grade 1), 7.7% IMRT (12 grade 4, 5 grade 3, 1 grade 2 and 23 grade 1). Osteoradionecrosis location depended on the primary tumor site and high-dose field in the mandible. CONCLUSIONS:Osteoradionecrosis events were significantly associated with higher dose irradiation to mandibular. Use of IMPT minimized excess irradiation of the mandible and consequently reduced the risk of osteoradionecrosis for oropharyngeal cancer.
Authors: Charles B Simone; David Ly; Tu D Dan; John Ondos; Holly Ning; Arnaud Belard; John O'Connell; Robert W Miller; Nicole L Simone Journal: Radiother Oncol Date: 2011-06-12 Impact factor: 6.280
Authors: Merav A Ben-David; Maximiliano Diamante; Jeffrey D Radawski; Karen A Vineberg; Cynthia Stroup; Carol-Anne Murdoch-Kinch; Samuel R Zwetchkenbaum; Avraham Eisbruch Journal: Int J Radiat Oncol Biol Phys Date: 2007-02-22 Impact factor: 7.038
Authors: Thomas Held; Thomas Tessonnier; Henrik Franke; Sebastian Regnery; Lukas Bauer; Katharina Weusthof; Semi Harrabi; Klaus Herfarth; Andrea Mairani; Jürgen Debus; Sebastian Adeberg Journal: Radiat Oncol Date: 2022-07-08 Impact factor: 4.309
Authors: Joseph K Kim; Jonathan E Leeman; Nadeem Riaz; Sean McBride; Chiaojung Jillian Tsai; Nancy Y Lee Journal: Curr Treat Options Oncol Date: 2018-05-09
Authors: Nicolette Taku; Li Wang; Adam S Garden; David I Rosenthal; G Brandon Gunn; William H Morrison; C David Fuller; Jack Phan; Jay P Reddy; Amy C Moreno; Michael T Spiotto; Gregory Chronowski; Shalin J Shah; Lauren L Mayo; Neil D Gross; Renata Ferrarotto; X Ronald Zhu; Xiaodong Zhang; Steven J Frank Journal: Curr Treat Options Oncol Date: 2021-06-04
Authors: Sarah E Nicholas; Wei Fu; Angela L Liang; Regina DeLuna; Luka Vujaskovic; Justin Bishop; Brandi R Page; Harry Quon; Christine Gourin; Carole Fakhry; David Eisele; Ana P Kiess Journal: Adv Radiat Oncol Date: 2021-03-02
Authors: Alexander D Sherry; Dario Pasalic; G Brandon Gunn; C David Fuller; Jack Phan; David I Rosenthal; William H Morrison; Erich M Sturgis; Neil D Gross; Maura L Gillison; Renata Ferrarotto; Adel K El-Naggar; Adam S Garden; Steven J Frank Journal: Int J Part Ther Date: 2021-06-25
Authors: G Brandon Gunn; Adam S Garden; Rong Ye; Noveen Ausat; Kristina R Dahlstrom; William H Morrison; C David Fuller; Jack Phan; Jay P Reddy; Shalin J Shah; Lauren L Mayo; Stephen G Chun; Gregory M Chronowski; Amy C Moreno; Jeffery N Myers; Ehab Y Hanna; Bita Esmaeli; Maura L Gillison; Renata Ferrarotto; Katherine A Hutcheson; Mark S Chambers; Lawrence E Ginsberg; Adel K El-Naggar; David I Rosenthal; Xiaorong Ronald Zhu; Steven J Frank Journal: Int J Part Ther Date: 2021-06-25