Selectively sparing the submandibular gland when level Ib lymph nodes are included in the radiation target volume: An initial safety analysis of a novel planning objective
Background: Submandibular gland (SMG) metastases are extremely rare in head and neck cancer, even in the presence of level Ib lymph node (LN) involvement. In recent years, we have contoured the SMG and specifically attempted to limit its dose exposure even in patients in whom the level Ib LN station...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Varra, Vamsi [verfasserIn] Ross, Richard B. [verfasserIn] Juloori, Aditya [verfasserIn] Campbell, Shauna [verfasserIn] Tom, Martin C. [verfasserIn] Joshi, Nikhil P. [verfasserIn] Woody, Neil M. [verfasserIn] Ward, Matthew C. [verfasserIn] Xia, Ping [verfasserIn] Koyfman, Shlomo A. [verfasserIn] Greskovich, John F. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2018 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: Oral oncology - Amsterdam [u.a.] : Elsevier Science, 1997, 89, Seite 79-83 |
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| Übergeordnetes Werk: |
volume:89 ; pages:79-83 |
| DOI / URN: |
10.1016/j.oraloncology.2018.12.021 |
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| Katalog-ID: |
ELV001617427 |
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| 245 | 1 | 0 | |a Selectively sparing the submandibular gland when level Ib lymph nodes are included in the radiation target volume: An initial safety analysis of a novel planning objective |
| 264 | 1 | |c 2018 | |
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| 520 | |a Background: Submandibular gland (SMG) metastases are extremely rare in head and neck cancer, even in the presence of level Ib lymph node (LN) involvement. In recent years, we have contoured the SMG and specifically attempted to limit its dose exposure even in patients in whom the level Ib LN station is targeted. This study reports our preliminary feasibility and safety experience with selective submandibular gland sparing.Methods: Patients with squamous cell cancer (SCC) of the oral cavity or oropharynx with T1-2, N0-3, M0 disease in whom at least a single level Ib lymph node region was included in the target volume were identified. All patients were treated from 2009 to 2014 with definitive or postoperative IMRT with or without chemotherapy. Patients with recurrent disease, previous radiation or treated palliatively were excluded.Results: A total of 174 patients met criteria for inclusion. Among the 185 level Ib LN stations that were deliberately targeted in the clinical treatment volume, 32 submandibular glands were contoured, excluded from the target volume and avoided during treatment planning. Mean dose to the spared SMG were reduced by 12% (66.6 Gy vs. 58.9 Gy, p < .001). None of these patients experienced any level 1b LN failures.Conclusion: Selective sparing of the submandibular gland when targeting the level 1b nodes in oral cavity and oropharynx cancer is feasible, reduces the mean dose to submandibular glands and does not result in increased level 1b nodal failure rates. Additional studies with larger cohorts are needed to validate this preliminary observation. | ||
| 650 | 4 | |a Head and neck cancer | |
| 650 | 4 | |a Oral cavity | |
| 650 | 4 | |a Oropharynx | |
| 650 | 4 | |a Radiation therapy | |
| 650 | 4 | |a IMRT | |
| 650 | 4 | |a Submandibular gland sparing | |
| 650 | 4 | |a Xerostomia | |
| 700 | 1 | |a Ross, Richard B. |e verfasserin |4 aut | |
| 700 | 1 | |a Juloori, Aditya |e verfasserin |0 (orcid)0000-0003-4507-6167 |4 aut | |
| 700 | 1 | |a Campbell, Shauna |e verfasserin |4 aut | |
| 700 | 1 | |a Tom, Martin C. |e verfasserin |4 aut | |
| 700 | 1 | |a Joshi, Nikhil P. |e verfasserin |4 aut | |
| 700 | 1 | |a Woody, Neil M. |e verfasserin |4 aut | |
| 700 | 1 | |a Ward, Matthew C. |e verfasserin |4 aut | |
| 700 | 1 | |a Xia, Ping |e verfasserin |4 aut | |
| 700 | 1 | |a Koyfman, Shlomo A. |e verfasserin |4 aut | |
| 700 | 1 | |a Greskovich, John F. |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Oral oncology |d Amsterdam [u.a.] : Elsevier Science, 1997 |g 89, Seite 79-83 |h Online-Ressource |w (DE-627)320498980 |w (DE-600)2011971-9 |w (DE-576)106869612 |x 1879-0593 |7 nnns |
| 773 | 1 | 8 | |g volume:89 |g pages:79-83 |
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2018 |
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2018 |
| allfields |
10.1016/j.oraloncology.2018.12.021 doi (DE-627)ELV001617427 (ELSEVIER)S1368-8375(18)30485-8 DE-627 ger DE-627 rda eng 610 DE-600 44.96 bkl 44.81 bkl Varra, Vamsi verfasserin (orcid)0000-0002-3548-3052 aut Selectively sparing the submandibular gland when level Ib lymph nodes are included in the radiation target volume: An initial safety analysis of a novel planning objective 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Submandibular gland (SMG) metastases are extremely rare in head and neck cancer, even in the presence of level Ib lymph node (LN) involvement. In recent years, we have contoured the SMG and specifically attempted to limit its dose exposure even in patients in whom the level Ib LN station is targeted. This study reports our preliminary feasibility and safety experience with selective submandibular gland sparing.Methods: Patients with squamous cell cancer (SCC) of the oral cavity or oropharynx with T1-2, N0-3, M0 disease in whom at least a single level Ib lymph node region was included in the target volume were identified. All patients were treated from 2009 to 2014 with definitive or postoperative IMRT with or without chemotherapy. Patients with recurrent disease, previous radiation or treated palliatively were excluded.Results: A total of 174 patients met criteria for inclusion. Among the 185 level Ib LN stations that were deliberately targeted in the clinical treatment volume, 32 submandibular glands were contoured, excluded from the target volume and avoided during treatment planning. Mean dose to the spared SMG were reduced by 12% (66.6 Gy vs. 58.9 Gy, p < .001). None of these patients experienced any level 1b LN failures.Conclusion: Selective sparing of the submandibular gland when targeting the level 1b nodes in oral cavity and oropharynx cancer is feasible, reduces the mean dose to submandibular glands and does not result in increased level 1b nodal failure rates. Additional studies with larger cohorts are needed to validate this preliminary observation. Head and neck cancer Oral cavity Oropharynx Radiation therapy IMRT Submandibular gland sparing Xerostomia Ross, Richard B. verfasserin aut Juloori, Aditya verfasserin (orcid)0000-0003-4507-6167 aut Campbell, Shauna verfasserin aut Tom, Martin C. verfasserin aut Joshi, Nikhil P. verfasserin aut Woody, Neil M. verfasserin aut Ward, Matthew C. verfasserin aut Xia, Ping verfasserin aut Koyfman, Shlomo A. verfasserin aut Greskovich, John F. verfasserin aut Enthalten in Oral oncology Amsterdam [u.a.] : Elsevier Science, 1997 89, Seite 79-83 Online-Ressource (DE-627)320498980 (DE-600)2011971-9 (DE-576)106869612 1879-0593 nnns volume:89 pages:79-83 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.96 Zahnmedizin 44.81 Onkologie AR 89 79-83 |
| spelling |
10.1016/j.oraloncology.2018.12.021 doi (DE-627)ELV001617427 (ELSEVIER)S1368-8375(18)30485-8 DE-627 ger DE-627 rda eng 610 DE-600 44.96 bkl 44.81 bkl Varra, Vamsi verfasserin (orcid)0000-0002-3548-3052 aut Selectively sparing the submandibular gland when level Ib lymph nodes are included in the radiation target volume: An initial safety analysis of a novel planning objective 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Submandibular gland (SMG) metastases are extremely rare in head and neck cancer, even in the presence of level Ib lymph node (LN) involvement. In recent years, we have contoured the SMG and specifically attempted to limit its dose exposure even in patients in whom the level Ib LN station is targeted. This study reports our preliminary feasibility and safety experience with selective submandibular gland sparing.Methods: Patients with squamous cell cancer (SCC) of the oral cavity or oropharynx with T1-2, N0-3, M0 disease in whom at least a single level Ib lymph node region was included in the target volume were identified. All patients were treated from 2009 to 2014 with definitive or postoperative IMRT with or without chemotherapy. Patients with recurrent disease, previous radiation or treated palliatively were excluded.Results: A total of 174 patients met criteria for inclusion. Among the 185 level Ib LN stations that were deliberately targeted in the clinical treatment volume, 32 submandibular glands were contoured, excluded from the target volume and avoided during treatment planning. Mean dose to the spared SMG were reduced by 12% (66.6 Gy vs. 58.9 Gy, p < .001). None of these patients experienced any level 1b LN failures.Conclusion: Selective sparing of the submandibular gland when targeting the level 1b nodes in oral cavity and oropharynx cancer is feasible, reduces the mean dose to submandibular glands and does not result in increased level 1b nodal failure rates. Additional studies with larger cohorts are needed to validate this preliminary observation. Head and neck cancer Oral cavity Oropharynx Radiation therapy IMRT Submandibular gland sparing Xerostomia Ross, Richard B. verfasserin aut Juloori, Aditya verfasserin (orcid)0000-0003-4507-6167 aut Campbell, Shauna verfasserin aut Tom, Martin C. verfasserin aut Joshi, Nikhil P. verfasserin aut Woody, Neil M. verfasserin aut Ward, Matthew C. verfasserin aut Xia, Ping verfasserin aut Koyfman, Shlomo A. verfasserin aut Greskovich, John F. verfasserin aut Enthalten in Oral oncology Amsterdam [u.a.] : Elsevier Science, 1997 89, Seite 79-83 Online-Ressource (DE-627)320498980 (DE-600)2011971-9 (DE-576)106869612 1879-0593 nnns volume:89 pages:79-83 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.96 Zahnmedizin 44.81 Onkologie AR 89 79-83 |
| allfields_unstemmed |
10.1016/j.oraloncology.2018.12.021 doi (DE-627)ELV001617427 (ELSEVIER)S1368-8375(18)30485-8 DE-627 ger DE-627 rda eng 610 DE-600 44.96 bkl 44.81 bkl Varra, Vamsi verfasserin (orcid)0000-0002-3548-3052 aut Selectively sparing the submandibular gland when level Ib lymph nodes are included in the radiation target volume: An initial safety analysis of a novel planning objective 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Submandibular gland (SMG) metastases are extremely rare in head and neck cancer, even in the presence of level Ib lymph node (LN) involvement. In recent years, we have contoured the SMG and specifically attempted to limit its dose exposure even in patients in whom the level Ib LN station is targeted. This study reports our preliminary feasibility and safety experience with selective submandibular gland sparing.Methods: Patients with squamous cell cancer (SCC) of the oral cavity or oropharynx with T1-2, N0-3, M0 disease in whom at least a single level Ib lymph node region was included in the target volume were identified. All patients were treated from 2009 to 2014 with definitive or postoperative IMRT with or without chemotherapy. Patients with recurrent disease, previous radiation or treated palliatively were excluded.Results: A total of 174 patients met criteria for inclusion. Among the 185 level Ib LN stations that were deliberately targeted in the clinical treatment volume, 32 submandibular glands were contoured, excluded from the target volume and avoided during treatment planning. Mean dose to the spared SMG were reduced by 12% (66.6 Gy vs. 58.9 Gy, p < .001). None of these patients experienced any level 1b LN failures.Conclusion: Selective sparing of the submandibular gland when targeting the level 1b nodes in oral cavity and oropharynx cancer is feasible, reduces the mean dose to submandibular glands and does not result in increased level 1b nodal failure rates. Additional studies with larger cohorts are needed to validate this preliminary observation. Head and neck cancer Oral cavity Oropharynx Radiation therapy IMRT Submandibular gland sparing Xerostomia Ross, Richard B. verfasserin aut Juloori, Aditya verfasserin (orcid)0000-0003-4507-6167 aut Campbell, Shauna verfasserin aut Tom, Martin C. verfasserin aut Joshi, Nikhil P. verfasserin aut Woody, Neil M. verfasserin aut Ward, Matthew C. verfasserin aut Xia, Ping verfasserin aut Koyfman, Shlomo A. verfasserin aut Greskovich, John F. verfasserin aut Enthalten in Oral oncology Amsterdam [u.a.] : Elsevier Science, 1997 89, Seite 79-83 Online-Ressource (DE-627)320498980 (DE-600)2011971-9 (DE-576)106869612 1879-0593 nnns volume:89 pages:79-83 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.96 Zahnmedizin 44.81 Onkologie AR 89 79-83 |
| allfieldsGer |
10.1016/j.oraloncology.2018.12.021 doi (DE-627)ELV001617427 (ELSEVIER)S1368-8375(18)30485-8 DE-627 ger DE-627 rda eng 610 DE-600 44.96 bkl 44.81 bkl Varra, Vamsi verfasserin (orcid)0000-0002-3548-3052 aut Selectively sparing the submandibular gland when level Ib lymph nodes are included in the radiation target volume: An initial safety analysis of a novel planning objective 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Submandibular gland (SMG) metastases are extremely rare in head and neck cancer, even in the presence of level Ib lymph node (LN) involvement. In recent years, we have contoured the SMG and specifically attempted to limit its dose exposure even in patients in whom the level Ib LN station is targeted. This study reports our preliminary feasibility and safety experience with selective submandibular gland sparing.Methods: Patients with squamous cell cancer (SCC) of the oral cavity or oropharynx with T1-2, N0-3, M0 disease in whom at least a single level Ib lymph node region was included in the target volume were identified. All patients were treated from 2009 to 2014 with definitive or postoperative IMRT with or without chemotherapy. Patients with recurrent disease, previous radiation or treated palliatively were excluded.Results: A total of 174 patients met criteria for inclusion. Among the 185 level Ib LN stations that were deliberately targeted in the clinical treatment volume, 32 submandibular glands were contoured, excluded from the target volume and avoided during treatment planning. Mean dose to the spared SMG were reduced by 12% (66.6 Gy vs. 58.9 Gy, p < .001). None of these patients experienced any level 1b LN failures.Conclusion: Selective sparing of the submandibular gland when targeting the level 1b nodes in oral cavity and oropharynx cancer is feasible, reduces the mean dose to submandibular glands and does not result in increased level 1b nodal failure rates. Additional studies with larger cohorts are needed to validate this preliminary observation. Head and neck cancer Oral cavity Oropharynx Radiation therapy IMRT Submandibular gland sparing Xerostomia Ross, Richard B. verfasserin aut Juloori, Aditya verfasserin (orcid)0000-0003-4507-6167 aut Campbell, Shauna verfasserin aut Tom, Martin C. verfasserin aut Joshi, Nikhil P. verfasserin aut Woody, Neil M. verfasserin aut Ward, Matthew C. verfasserin aut Xia, Ping verfasserin aut Koyfman, Shlomo A. verfasserin aut Greskovich, John F. verfasserin aut Enthalten in Oral oncology Amsterdam [u.a.] : Elsevier Science, 1997 89, Seite 79-83 Online-Ressource (DE-627)320498980 (DE-600)2011971-9 (DE-576)106869612 1879-0593 nnns volume:89 pages:79-83 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.96 Zahnmedizin 44.81 Onkologie AR 89 79-83 |
| allfieldsSound |
10.1016/j.oraloncology.2018.12.021 doi (DE-627)ELV001617427 (ELSEVIER)S1368-8375(18)30485-8 DE-627 ger DE-627 rda eng 610 DE-600 44.96 bkl 44.81 bkl Varra, Vamsi verfasserin (orcid)0000-0002-3548-3052 aut Selectively sparing the submandibular gland when level Ib lymph nodes are included in the radiation target volume: An initial safety analysis of a novel planning objective 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Submandibular gland (SMG) metastases are extremely rare in head and neck cancer, even in the presence of level Ib lymph node (LN) involvement. In recent years, we have contoured the SMG and specifically attempted to limit its dose exposure even in patients in whom the level Ib LN station is targeted. This study reports our preliminary feasibility and safety experience with selective submandibular gland sparing.Methods: Patients with squamous cell cancer (SCC) of the oral cavity or oropharynx with T1-2, N0-3, M0 disease in whom at least a single level Ib lymph node region was included in the target volume were identified. All patients were treated from 2009 to 2014 with definitive or postoperative IMRT with or without chemotherapy. Patients with recurrent disease, previous radiation or treated palliatively were excluded.Results: A total of 174 patients met criteria for inclusion. Among the 185 level Ib LN stations that were deliberately targeted in the clinical treatment volume, 32 submandibular glands were contoured, excluded from the target volume and avoided during treatment planning. Mean dose to the spared SMG were reduced by 12% (66.6 Gy vs. 58.9 Gy, p < .001). None of these patients experienced any level 1b LN failures.Conclusion: Selective sparing of the submandibular gland when targeting the level 1b nodes in oral cavity and oropharynx cancer is feasible, reduces the mean dose to submandibular glands and does not result in increased level 1b nodal failure rates. Additional studies with larger cohorts are needed to validate this preliminary observation. Head and neck cancer Oral cavity Oropharynx Radiation therapy IMRT Submandibular gland sparing Xerostomia Ross, Richard B. verfasserin aut Juloori, Aditya verfasserin (orcid)0000-0003-4507-6167 aut Campbell, Shauna verfasserin aut Tom, Martin C. verfasserin aut Joshi, Nikhil P. verfasserin aut Woody, Neil M. verfasserin aut Ward, Matthew C. verfasserin aut Xia, Ping verfasserin aut Koyfman, Shlomo A. verfasserin aut Greskovich, John F. verfasserin aut Enthalten in Oral oncology Amsterdam [u.a.] : Elsevier Science, 1997 89, Seite 79-83 Online-Ressource (DE-627)320498980 (DE-600)2011971-9 (DE-576)106869612 1879-0593 nnns volume:89 pages:79-83 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.96 Zahnmedizin 44.81 Onkologie AR 89 79-83 |
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Enthalten in Oral oncology 89, Seite 79-83 volume:89 pages:79-83 |
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Varra, Vamsi @@aut@@ Ross, Richard B. @@aut@@ Juloori, Aditya @@aut@@ Campbell, Shauna @@aut@@ Tom, Martin C. @@aut@@ Joshi, Nikhil P. @@aut@@ Woody, Neil M. @@aut@@ Ward, Matthew C. @@aut@@ Xia, Ping @@aut@@ Koyfman, Shlomo A. @@aut@@ Greskovich, John F. @@aut@@ |
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2018-01-01T00:00:00Z |
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Varra, Vamsi |
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Varra, Vamsi ddc 610 bkl 44.96 bkl 44.81 misc Head and neck cancer misc Oral cavity misc Oropharynx misc Radiation therapy misc IMRT misc Submandibular gland sparing misc Xerostomia Selectively sparing the submandibular gland when level Ib lymph nodes are included in the radiation target volume: An initial safety analysis of a novel planning objective |
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610 DE-600 44.96 bkl 44.81 bkl Selectively sparing the submandibular gland when level Ib lymph nodes are included in the radiation target volume: An initial safety analysis of a novel planning objective Head and neck cancer Oral cavity Oropharynx Radiation therapy IMRT Submandibular gland sparing Xerostomia |
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ddc 610 bkl 44.96 bkl 44.81 misc Head and neck cancer misc Oral cavity misc Oropharynx misc Radiation therapy misc IMRT misc Submandibular gland sparing misc Xerostomia |
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ddc 610 bkl 44.96 bkl 44.81 misc Head and neck cancer misc Oral cavity misc Oropharynx misc Radiation therapy misc IMRT misc Submandibular gland sparing misc Xerostomia |
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Selectively sparing the submandibular gland when level Ib lymph nodes are included in the radiation target volume: An initial safety analysis of a novel planning objective |
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Selectively sparing the submandibular gland when level Ib lymph nodes are included in the radiation target volume: An initial safety analysis of a novel planning objective |
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Varra, Vamsi Ross, Richard B. Juloori, Aditya Campbell, Shauna Tom, Martin C. Joshi, Nikhil P. Woody, Neil M. Ward, Matthew C. Xia, Ping Koyfman, Shlomo A. Greskovich, John F. |
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10.1016/j.oraloncology.2018.12.021 |
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selectively sparing the submandibular gland when level ib lymph nodes are included in the radiation target volume: an initial safety analysis of a novel planning objective |
| title_auth |
Selectively sparing the submandibular gland when level Ib lymph nodes are included in the radiation target volume: An initial safety analysis of a novel planning objective |
| abstract |
Background: Submandibular gland (SMG) metastases are extremely rare in head and neck cancer, even in the presence of level Ib lymph node (LN) involvement. In recent years, we have contoured the SMG and specifically attempted to limit its dose exposure even in patients in whom the level Ib LN station is targeted. This study reports our preliminary feasibility and safety experience with selective submandibular gland sparing.Methods: Patients with squamous cell cancer (SCC) of the oral cavity or oropharynx with T1-2, N0-3, M0 disease in whom at least a single level Ib lymph node region was included in the target volume were identified. All patients were treated from 2009 to 2014 with definitive or postoperative IMRT with or without chemotherapy. Patients with recurrent disease, previous radiation or treated palliatively were excluded.Results: A total of 174 patients met criteria for inclusion. Among the 185 level Ib LN stations that were deliberately targeted in the clinical treatment volume, 32 submandibular glands were contoured, excluded from the target volume and avoided during treatment planning. Mean dose to the spared SMG were reduced by 12% (66.6 Gy vs. 58.9 Gy, p < .001). None of these patients experienced any level 1b LN failures.Conclusion: Selective sparing of the submandibular gland when targeting the level 1b nodes in oral cavity and oropharynx cancer is feasible, reduces the mean dose to submandibular glands and does not result in increased level 1b nodal failure rates. Additional studies with larger cohorts are needed to validate this preliminary observation. |
| abstractGer |
Background: Submandibular gland (SMG) metastases are extremely rare in head and neck cancer, even in the presence of level Ib lymph node (LN) involvement. In recent years, we have contoured the SMG and specifically attempted to limit its dose exposure even in patients in whom the level Ib LN station is targeted. This study reports our preliminary feasibility and safety experience with selective submandibular gland sparing.Methods: Patients with squamous cell cancer (SCC) of the oral cavity or oropharynx with T1-2, N0-3, M0 disease in whom at least a single level Ib lymph node region was included in the target volume were identified. All patients were treated from 2009 to 2014 with definitive or postoperative IMRT with or without chemotherapy. Patients with recurrent disease, previous radiation or treated palliatively were excluded.Results: A total of 174 patients met criteria for inclusion. Among the 185 level Ib LN stations that were deliberately targeted in the clinical treatment volume, 32 submandibular glands were contoured, excluded from the target volume and avoided during treatment planning. Mean dose to the spared SMG were reduced by 12% (66.6 Gy vs. 58.9 Gy, p < .001). None of these patients experienced any level 1b LN failures.Conclusion: Selective sparing of the submandibular gland when targeting the level 1b nodes in oral cavity and oropharynx cancer is feasible, reduces the mean dose to submandibular glands and does not result in increased level 1b nodal failure rates. Additional studies with larger cohorts are needed to validate this preliminary observation. |
| abstract_unstemmed |
Background: Submandibular gland (SMG) metastases are extremely rare in head and neck cancer, even in the presence of level Ib lymph node (LN) involvement. In recent years, we have contoured the SMG and specifically attempted to limit its dose exposure even in patients in whom the level Ib LN station is targeted. This study reports our preliminary feasibility and safety experience with selective submandibular gland sparing.Methods: Patients with squamous cell cancer (SCC) of the oral cavity or oropharynx with T1-2, N0-3, M0 disease in whom at least a single level Ib lymph node region was included in the target volume were identified. All patients were treated from 2009 to 2014 with definitive or postoperative IMRT with or without chemotherapy. Patients with recurrent disease, previous radiation or treated palliatively were excluded.Results: A total of 174 patients met criteria for inclusion. Among the 185 level Ib LN stations that were deliberately targeted in the clinical treatment volume, 32 submandibular glands were contoured, excluded from the target volume and avoided during treatment planning. Mean dose to the spared SMG were reduced by 12% (66.6 Gy vs. 58.9 Gy, p < .001). None of these patients experienced any level 1b LN failures.Conclusion: Selective sparing of the submandibular gland when targeting the level 1b nodes in oral cavity and oropharynx cancer is feasible, reduces the mean dose to submandibular glands and does not result in increased level 1b nodal failure rates. Additional studies with larger cohorts are needed to validate this preliminary observation. |
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Selectively sparing the submandibular gland when level Ib lymph nodes are included in the radiation target volume: An initial safety analysis of a novel planning objective |
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Ross, Richard B. Juloori, Aditya Campbell, Shauna Tom, Martin C. Joshi, Nikhil P. Woody, Neil M. Ward, Matthew C. Xia, Ping Koyfman, Shlomo A. Greskovich, John F. |
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| score |
7.3998404 |