Accounting for fractionation and heterogeneous dose distributions in the modelling of osteoradionecrosis in oropharyngeal carcinoma treatment
Background and purpose: Osteoradionecrosis (ORN) of the mandible is a severe complication following radiotherapy (RT). With a renewed interest in hypofractionation for head and neck radiotherapy, more information concerning ORN development after high fraction doses is important. The aim of this expl...
Ausführliche Beschreibung
Autor*in: |
Verduijn, Gerda M. [verfasserIn] Sijtsema, Nienke D. [verfasserIn] van Norden, Yvette [verfasserIn] Heemsbergen, Wilma D. [verfasserIn] Mast, Hetty [verfasserIn] Sewnaik, Aniel [verfasserIn] Chin, Denzel [verfasserIn] Baker, Sarah [verfasserIn] Capala, Marta E. [verfasserIn] van der Lugt, Aad [verfasserIn] van Meerten, Esther [verfasserIn] Hoogeman, Mischa S. [verfasserIn] Petit, Steven F. [verfasserIn] |
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Format: |
E-Artikel |
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Sprache: |
Englisch |
Erschienen: |
2023 |
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Schlagwörter: |
Equivalent uniform doses (EUD) |
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Übergeordnetes Werk: |
Enthalten in: Radiotherapy and oncology - Amsterdam [u.a.] : Elsevier Science, 1983, 188 |
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Übergeordnetes Werk: |
volume:188 |
DOI / URN: |
10.1016/j.radonc.2023.109889 |
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Katalog-ID: |
ELV065224531 |
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100 | 1 | |a Verduijn, Gerda M. |e verfasserin |0 (orcid)0000-0002-3513-6544 |4 aut | |
245 | 1 | 0 | |a Accounting for fractionation and heterogeneous dose distributions in the modelling of osteoradionecrosis in oropharyngeal carcinoma treatment |
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520 | |a Background and purpose: Osteoradionecrosis (ORN) of the mandible is a severe complication following radiotherapy (RT). With a renewed interest in hypofractionation for head and neck radiotherapy, more information concerning ORN development after high fraction doses is important. The aim of this explorative study was to develop a model for ORN risk prediction applicable across different fractionation schemes using Equivalent Uniform Doses (EUD).Material and methods: We performed a retrospective cohort study in 334 oropharyngeal squamous cell carcinoma (OPSCC) patients treated with either a hypofractionated Stereotactic Body Radiation Therapy (HF-SBRT) boost or conventional Intensity Modulated Radiation Therapy (IMRT). ORN was scored with the CTCAE v5.0. HF-SBRT and IMRT dose distributions were converted into equivalent dose in 2 Gy fractions (α/β = 0.85 Gy) and analyzed using EUD. The parameter a that led to an EUD that best discriminated patients with and without grade ≥ 2 ORN was selected. Patient and treatment-related risk factors of ORN were analyzed with uni- and multivariable regression analysis.Results: A total of 32 patients (9.6%) developed ORN grade ≥ 2. An EUD(a = 8) best discriminated between ORN and non-ORN (AUC = 0.71). In multivariable regression, pre-RT extractions (SHR = 2.34; p = 0.012), mandibular volume (SHR = 1.04; p = 0.003), and the EUD(a = 8) (SHR = 1.14; p < 0.001) were significantly associated with ORN.Conclusion: Risk models for ORN based on conventional DVH parameters cannot be directly applied to HF-SBRT fractionation schemes and dose distributions. However, after correcting for fractionation and non-uniform dose distributions using EUD, a single model can distinguish between ORN and non-ORN after conventionally fractionated radiotherapy and hypofractionated boost treatments. | ||
650 | 4 | |a Equivalent uniform doses (EUD) | |
650 | 4 | |a Osteoradionecrosis (ORN) | |
650 | 4 | |a Oropharyngeal squamous cell carcinoma (OPSCC) | |
650 | 4 | |a Radiotherapy (RT) | |
650 | 4 | |a Hypofractionation | |
700 | 1 | |a Sijtsema, Nienke D. |e verfasserin |0 (orcid)0000-0001-7928-1578 |4 aut | |
700 | 1 | |a van Norden, Yvette |e verfasserin |4 aut | |
700 | 1 | |a Heemsbergen, Wilma D. |e verfasserin |0 (orcid)0000-0003-2144-0729 |4 aut | |
700 | 1 | |a Mast, Hetty |e verfasserin |0 (orcid)0000-0003-0559-543X |4 aut | |
700 | 1 | |a Sewnaik, Aniel |e verfasserin |4 aut | |
700 | 1 | |a Chin, Denzel |e verfasserin |4 aut | |
700 | 1 | |a Baker, Sarah |e verfasserin |4 aut | |
700 | 1 | |a Capala, Marta E. |e verfasserin |4 aut | |
700 | 1 | |a van der Lugt, Aad |e verfasserin |4 aut | |
700 | 1 | |a van Meerten, Esther |e verfasserin |4 aut | |
700 | 1 | |a Hoogeman, Mischa S. |e verfasserin |0 (orcid)0000-0002-4264-9903 |4 aut | |
700 | 1 | |a Petit, Steven F. |e verfasserin |0 (orcid)0000-0001-9787-8239 |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Radiotherapy and oncology |d Amsterdam [u.a.] : Elsevier Science, 1983 |g 188 |h Online-Ressource |w (DE-627)306710110 |w (DE-600)1500707-8 |w (DE-576)082435731 |x 1879-0887 |7 nnns |
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2023 |
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2023 |
allfields |
10.1016/j.radonc.2023.109889 doi (DE-627)ELV065224531 (ELSEVIER)S0167-8140(23)89783-3 DE-627 ger DE-627 rda eng 610 VZ 44.81 bkl 44.64 bkl Verduijn, Gerda M. verfasserin (orcid)0000-0002-3513-6544 aut Accounting for fractionation and heterogeneous dose distributions in the modelling of osteoradionecrosis in oropharyngeal carcinoma treatment 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background and purpose: Osteoradionecrosis (ORN) of the mandible is a severe complication following radiotherapy (RT). With a renewed interest in hypofractionation for head and neck radiotherapy, more information concerning ORN development after high fraction doses is important. The aim of this explorative study was to develop a model for ORN risk prediction applicable across different fractionation schemes using Equivalent Uniform Doses (EUD).Material and methods: We performed a retrospective cohort study in 334 oropharyngeal squamous cell carcinoma (OPSCC) patients treated with either a hypofractionated Stereotactic Body Radiation Therapy (HF-SBRT) boost or conventional Intensity Modulated Radiation Therapy (IMRT). ORN was scored with the CTCAE v5.0. HF-SBRT and IMRT dose distributions were converted into equivalent dose in 2 Gy fractions (α/β = 0.85 Gy) and analyzed using EUD. The parameter a that led to an EUD that best discriminated patients with and without grade ≥ 2 ORN was selected. Patient and treatment-related risk factors of ORN were analyzed with uni- and multivariable regression analysis.Results: A total of 32 patients (9.6%) developed ORN grade ≥ 2. An EUD(a = 8) best discriminated between ORN and non-ORN (AUC = 0.71). In multivariable regression, pre-RT extractions (SHR = 2.34; p = 0.012), mandibular volume (SHR = 1.04; p = 0.003), and the EUD(a = 8) (SHR = 1.14; p < 0.001) were significantly associated with ORN.Conclusion: Risk models for ORN based on conventional DVH parameters cannot be directly applied to HF-SBRT fractionation schemes and dose distributions. However, after correcting for fractionation and non-uniform dose distributions using EUD, a single model can distinguish between ORN and non-ORN after conventionally fractionated radiotherapy and hypofractionated boost treatments. Equivalent uniform doses (EUD) Osteoradionecrosis (ORN) Oropharyngeal squamous cell carcinoma (OPSCC) Radiotherapy (RT) Hypofractionation Sijtsema, Nienke D. verfasserin (orcid)0000-0001-7928-1578 aut van Norden, Yvette verfasserin aut Heemsbergen, Wilma D. verfasserin (orcid)0000-0003-2144-0729 aut Mast, Hetty verfasserin (orcid)0000-0003-0559-543X aut Sewnaik, Aniel verfasserin aut Chin, Denzel verfasserin aut Baker, Sarah verfasserin aut Capala, Marta E. verfasserin aut van der Lugt, Aad verfasserin aut van Meerten, Esther verfasserin aut Hoogeman, Mischa S. verfasserin (orcid)0000-0002-4264-9903 aut Petit, Steven F. verfasserin (orcid)0000-0001-9787-8239 aut Enthalten in Radiotherapy and oncology Amsterdam [u.a.] : Elsevier Science, 1983 188 Online-Ressource (DE-627)306710110 (DE-600)1500707-8 (DE-576)082435731 1879-0887 nnns volume:188 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 Onkologie VZ 44.64 Radiologie VZ AR 188 |
spelling |
10.1016/j.radonc.2023.109889 doi (DE-627)ELV065224531 (ELSEVIER)S0167-8140(23)89783-3 DE-627 ger DE-627 rda eng 610 VZ 44.81 bkl 44.64 bkl Verduijn, Gerda M. verfasserin (orcid)0000-0002-3513-6544 aut Accounting for fractionation and heterogeneous dose distributions in the modelling of osteoradionecrosis in oropharyngeal carcinoma treatment 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background and purpose: Osteoradionecrosis (ORN) of the mandible is a severe complication following radiotherapy (RT). With a renewed interest in hypofractionation for head and neck radiotherapy, more information concerning ORN development after high fraction doses is important. The aim of this explorative study was to develop a model for ORN risk prediction applicable across different fractionation schemes using Equivalent Uniform Doses (EUD).Material and methods: We performed a retrospective cohort study in 334 oropharyngeal squamous cell carcinoma (OPSCC) patients treated with either a hypofractionated Stereotactic Body Radiation Therapy (HF-SBRT) boost or conventional Intensity Modulated Radiation Therapy (IMRT). ORN was scored with the CTCAE v5.0. HF-SBRT and IMRT dose distributions were converted into equivalent dose in 2 Gy fractions (α/β = 0.85 Gy) and analyzed using EUD. The parameter a that led to an EUD that best discriminated patients with and without grade ≥ 2 ORN was selected. Patient and treatment-related risk factors of ORN were analyzed with uni- and multivariable regression analysis.Results: A total of 32 patients (9.6%) developed ORN grade ≥ 2. An EUD(a = 8) best discriminated between ORN and non-ORN (AUC = 0.71). In multivariable regression, pre-RT extractions (SHR = 2.34; p = 0.012), mandibular volume (SHR = 1.04; p = 0.003), and the EUD(a = 8) (SHR = 1.14; p < 0.001) were significantly associated with ORN.Conclusion: Risk models for ORN based on conventional DVH parameters cannot be directly applied to HF-SBRT fractionation schemes and dose distributions. However, after correcting for fractionation and non-uniform dose distributions using EUD, a single model can distinguish between ORN and non-ORN after conventionally fractionated radiotherapy and hypofractionated boost treatments. Equivalent uniform doses (EUD) Osteoradionecrosis (ORN) Oropharyngeal squamous cell carcinoma (OPSCC) Radiotherapy (RT) Hypofractionation Sijtsema, Nienke D. verfasserin (orcid)0000-0001-7928-1578 aut van Norden, Yvette verfasserin aut Heemsbergen, Wilma D. verfasserin (orcid)0000-0003-2144-0729 aut Mast, Hetty verfasserin (orcid)0000-0003-0559-543X aut Sewnaik, Aniel verfasserin aut Chin, Denzel verfasserin aut Baker, Sarah verfasserin aut Capala, Marta E. verfasserin aut van der Lugt, Aad verfasserin aut van Meerten, Esther verfasserin aut Hoogeman, Mischa S. verfasserin (orcid)0000-0002-4264-9903 aut Petit, Steven F. verfasserin (orcid)0000-0001-9787-8239 aut Enthalten in Radiotherapy and oncology Amsterdam [u.a.] : Elsevier Science, 1983 188 Online-Ressource (DE-627)306710110 (DE-600)1500707-8 (DE-576)082435731 1879-0887 nnns volume:188 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 Onkologie VZ 44.64 Radiologie VZ AR 188 |
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10.1016/j.radonc.2023.109889 doi (DE-627)ELV065224531 (ELSEVIER)S0167-8140(23)89783-3 DE-627 ger DE-627 rda eng 610 VZ 44.81 bkl 44.64 bkl Verduijn, Gerda M. verfasserin (orcid)0000-0002-3513-6544 aut Accounting for fractionation and heterogeneous dose distributions in the modelling of osteoradionecrosis in oropharyngeal carcinoma treatment 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background and purpose: Osteoradionecrosis (ORN) of the mandible is a severe complication following radiotherapy (RT). With a renewed interest in hypofractionation for head and neck radiotherapy, more information concerning ORN development after high fraction doses is important. The aim of this explorative study was to develop a model for ORN risk prediction applicable across different fractionation schemes using Equivalent Uniform Doses (EUD).Material and methods: We performed a retrospective cohort study in 334 oropharyngeal squamous cell carcinoma (OPSCC) patients treated with either a hypofractionated Stereotactic Body Radiation Therapy (HF-SBRT) boost or conventional Intensity Modulated Radiation Therapy (IMRT). ORN was scored with the CTCAE v5.0. HF-SBRT and IMRT dose distributions were converted into equivalent dose in 2 Gy fractions (α/β = 0.85 Gy) and analyzed using EUD. The parameter a that led to an EUD that best discriminated patients with and without grade ≥ 2 ORN was selected. Patient and treatment-related risk factors of ORN were analyzed with uni- and multivariable regression analysis.Results: A total of 32 patients (9.6%) developed ORN grade ≥ 2. An EUD(a = 8) best discriminated between ORN and non-ORN (AUC = 0.71). In multivariable regression, pre-RT extractions (SHR = 2.34; p = 0.012), mandibular volume (SHR = 1.04; p = 0.003), and the EUD(a = 8) (SHR = 1.14; p < 0.001) were significantly associated with ORN.Conclusion: Risk models for ORN based on conventional DVH parameters cannot be directly applied to HF-SBRT fractionation schemes and dose distributions. However, after correcting for fractionation and non-uniform dose distributions using EUD, a single model can distinguish between ORN and non-ORN after conventionally fractionated radiotherapy and hypofractionated boost treatments. Equivalent uniform doses (EUD) Osteoradionecrosis (ORN) Oropharyngeal squamous cell carcinoma (OPSCC) Radiotherapy (RT) Hypofractionation Sijtsema, Nienke D. verfasserin (orcid)0000-0001-7928-1578 aut van Norden, Yvette verfasserin aut Heemsbergen, Wilma D. verfasserin (orcid)0000-0003-2144-0729 aut Mast, Hetty verfasserin (orcid)0000-0003-0559-543X aut Sewnaik, Aniel verfasserin aut Chin, Denzel verfasserin aut Baker, Sarah verfasserin aut Capala, Marta E. verfasserin aut van der Lugt, Aad verfasserin aut van Meerten, Esther verfasserin aut Hoogeman, Mischa S. verfasserin (orcid)0000-0002-4264-9903 aut Petit, Steven F. verfasserin (orcid)0000-0001-9787-8239 aut Enthalten in Radiotherapy and oncology Amsterdam [u.a.] : Elsevier Science, 1983 188 Online-Ressource (DE-627)306710110 (DE-600)1500707-8 (DE-576)082435731 1879-0887 nnns volume:188 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 Onkologie VZ 44.64 Radiologie VZ AR 188 |
allfieldsGer |
10.1016/j.radonc.2023.109889 doi (DE-627)ELV065224531 (ELSEVIER)S0167-8140(23)89783-3 DE-627 ger DE-627 rda eng 610 VZ 44.81 bkl 44.64 bkl Verduijn, Gerda M. verfasserin (orcid)0000-0002-3513-6544 aut Accounting for fractionation and heterogeneous dose distributions in the modelling of osteoradionecrosis in oropharyngeal carcinoma treatment 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background and purpose: Osteoradionecrosis (ORN) of the mandible is a severe complication following radiotherapy (RT). With a renewed interest in hypofractionation for head and neck radiotherapy, more information concerning ORN development after high fraction doses is important. The aim of this explorative study was to develop a model for ORN risk prediction applicable across different fractionation schemes using Equivalent Uniform Doses (EUD).Material and methods: We performed a retrospective cohort study in 334 oropharyngeal squamous cell carcinoma (OPSCC) patients treated with either a hypofractionated Stereotactic Body Radiation Therapy (HF-SBRT) boost or conventional Intensity Modulated Radiation Therapy (IMRT). ORN was scored with the CTCAE v5.0. HF-SBRT and IMRT dose distributions were converted into equivalent dose in 2 Gy fractions (α/β = 0.85 Gy) and analyzed using EUD. The parameter a that led to an EUD that best discriminated patients with and without grade ≥ 2 ORN was selected. Patient and treatment-related risk factors of ORN were analyzed with uni- and multivariable regression analysis.Results: A total of 32 patients (9.6%) developed ORN grade ≥ 2. An EUD(a = 8) best discriminated between ORN and non-ORN (AUC = 0.71). In multivariable regression, pre-RT extractions (SHR = 2.34; p = 0.012), mandibular volume (SHR = 1.04; p = 0.003), and the EUD(a = 8) (SHR = 1.14; p < 0.001) were significantly associated with ORN.Conclusion: Risk models for ORN based on conventional DVH parameters cannot be directly applied to HF-SBRT fractionation schemes and dose distributions. However, after correcting for fractionation and non-uniform dose distributions using EUD, a single model can distinguish between ORN and non-ORN after conventionally fractionated radiotherapy and hypofractionated boost treatments. Equivalent uniform doses (EUD) Osteoradionecrosis (ORN) Oropharyngeal squamous cell carcinoma (OPSCC) Radiotherapy (RT) Hypofractionation Sijtsema, Nienke D. verfasserin (orcid)0000-0001-7928-1578 aut van Norden, Yvette verfasserin aut Heemsbergen, Wilma D. verfasserin (orcid)0000-0003-2144-0729 aut Mast, Hetty verfasserin (orcid)0000-0003-0559-543X aut Sewnaik, Aniel verfasserin aut Chin, Denzel verfasserin aut Baker, Sarah verfasserin aut Capala, Marta E. verfasserin aut van der Lugt, Aad verfasserin aut van Meerten, Esther verfasserin aut Hoogeman, Mischa S. verfasserin (orcid)0000-0002-4264-9903 aut Petit, Steven F. verfasserin (orcid)0000-0001-9787-8239 aut Enthalten in Radiotherapy and oncology Amsterdam [u.a.] : Elsevier Science, 1983 188 Online-Ressource (DE-627)306710110 (DE-600)1500707-8 (DE-576)082435731 1879-0887 nnns volume:188 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 Onkologie VZ 44.64 Radiologie VZ AR 188 |
allfieldsSound |
10.1016/j.radonc.2023.109889 doi (DE-627)ELV065224531 (ELSEVIER)S0167-8140(23)89783-3 DE-627 ger DE-627 rda eng 610 VZ 44.81 bkl 44.64 bkl Verduijn, Gerda M. verfasserin (orcid)0000-0002-3513-6544 aut Accounting for fractionation and heterogeneous dose distributions in the modelling of osteoradionecrosis in oropharyngeal carcinoma treatment 2023 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background and purpose: Osteoradionecrosis (ORN) of the mandible is a severe complication following radiotherapy (RT). With a renewed interest in hypofractionation for head and neck radiotherapy, more information concerning ORN development after high fraction doses is important. The aim of this explorative study was to develop a model for ORN risk prediction applicable across different fractionation schemes using Equivalent Uniform Doses (EUD).Material and methods: We performed a retrospective cohort study in 334 oropharyngeal squamous cell carcinoma (OPSCC) patients treated with either a hypofractionated Stereotactic Body Radiation Therapy (HF-SBRT) boost or conventional Intensity Modulated Radiation Therapy (IMRT). ORN was scored with the CTCAE v5.0. HF-SBRT and IMRT dose distributions were converted into equivalent dose in 2 Gy fractions (α/β = 0.85 Gy) and analyzed using EUD. The parameter a that led to an EUD that best discriminated patients with and without grade ≥ 2 ORN was selected. Patient and treatment-related risk factors of ORN were analyzed with uni- and multivariable regression analysis.Results: A total of 32 patients (9.6%) developed ORN grade ≥ 2. An EUD(a = 8) best discriminated between ORN and non-ORN (AUC = 0.71). In multivariable regression, pre-RT extractions (SHR = 2.34; p = 0.012), mandibular volume (SHR = 1.04; p = 0.003), and the EUD(a = 8) (SHR = 1.14; p < 0.001) were significantly associated with ORN.Conclusion: Risk models for ORN based on conventional DVH parameters cannot be directly applied to HF-SBRT fractionation schemes and dose distributions. However, after correcting for fractionation and non-uniform dose distributions using EUD, a single model can distinguish between ORN and non-ORN after conventionally fractionated radiotherapy and hypofractionated boost treatments. Equivalent uniform doses (EUD) Osteoradionecrosis (ORN) Oropharyngeal squamous cell carcinoma (OPSCC) Radiotherapy (RT) Hypofractionation Sijtsema, Nienke D. verfasserin (orcid)0000-0001-7928-1578 aut van Norden, Yvette verfasserin aut Heemsbergen, Wilma D. verfasserin (orcid)0000-0003-2144-0729 aut Mast, Hetty verfasserin (orcid)0000-0003-0559-543X aut Sewnaik, Aniel verfasserin aut Chin, Denzel verfasserin aut Baker, Sarah verfasserin aut Capala, Marta E. verfasserin aut van der Lugt, Aad verfasserin aut van Meerten, Esther verfasserin aut Hoogeman, Mischa S. verfasserin (orcid)0000-0002-4264-9903 aut Petit, Steven F. verfasserin (orcid)0000-0001-9787-8239 aut Enthalten in Radiotherapy and oncology Amsterdam [u.a.] : Elsevier Science, 1983 188 Online-Ressource (DE-627)306710110 (DE-600)1500707-8 (DE-576)082435731 1879-0887 nnns volume:188 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 Onkologie VZ 44.64 Radiologie VZ AR 188 |
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Enthalten in Radiotherapy and oncology 188 volume:188 |
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Enthalten in Radiotherapy and oncology 188 volume:188 |
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Equivalent uniform doses (EUD) Osteoradionecrosis (ORN) Oropharyngeal squamous cell carcinoma (OPSCC) Radiotherapy (RT) Hypofractionation |
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Radiotherapy and oncology |
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Verduijn, Gerda M. @@aut@@ Sijtsema, Nienke D. @@aut@@ van Norden, Yvette @@aut@@ Heemsbergen, Wilma D. @@aut@@ Mast, Hetty @@aut@@ Sewnaik, Aniel @@aut@@ Chin, Denzel @@aut@@ Baker, Sarah @@aut@@ Capala, Marta E. @@aut@@ van der Lugt, Aad @@aut@@ van Meerten, Esther @@aut@@ Hoogeman, Mischa S. @@aut@@ Petit, Steven F. @@aut@@ |
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2023-01-01T00:00:00Z |
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With a renewed interest in hypofractionation for head and neck radiotherapy, more information concerning ORN development after high fraction doses is important. The aim of this explorative study was to develop a model for ORN risk prediction applicable across different fractionation schemes using Equivalent Uniform Doses (EUD).Material and methods: We performed a retrospective cohort study in 334 oropharyngeal squamous cell carcinoma (OPSCC) patients treated with either a hypofractionated Stereotactic Body Radiation Therapy (HF-SBRT) boost or conventional Intensity Modulated Radiation Therapy (IMRT). ORN was scored with the CTCAE v5.0. HF-SBRT and IMRT dose distributions were converted into equivalent dose in 2 Gy fractions (α/β = 0.85 Gy) and analyzed using EUD. The parameter a that led to an EUD that best discriminated patients with and without grade ≥ 2 ORN was selected. Patient and treatment-related risk factors of ORN were analyzed with uni- and multivariable regression analysis.Results: A total of 32 patients (9.6%) developed ORN grade ≥ 2. An EUD(a = 8) best discriminated between ORN and non-ORN (AUC = 0.71). In multivariable regression, pre-RT extractions (SHR = 2.34; p = 0.012), mandibular volume (SHR = 1.04; p = 0.003), and the EUD(a = 8) (SHR = 1.14; p < 0.001) were significantly associated with ORN.Conclusion: Risk models for ORN based on conventional DVH parameters cannot be directly applied to HF-SBRT fractionation schemes and dose distributions. 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Verduijn, Gerda M. |
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Verduijn, Gerda M. ddc 610 bkl 44.81 bkl 44.64 misc Equivalent uniform doses (EUD) misc Osteoradionecrosis (ORN) misc Oropharyngeal squamous cell carcinoma (OPSCC) misc Radiotherapy (RT) misc Hypofractionation Accounting for fractionation and heterogeneous dose distributions in the modelling of osteoradionecrosis in oropharyngeal carcinoma treatment |
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610 VZ 44.81 bkl 44.64 bkl Accounting for fractionation and heterogeneous dose distributions in the modelling of osteoradionecrosis in oropharyngeal carcinoma treatment Equivalent uniform doses (EUD) Osteoradionecrosis (ORN) Oropharyngeal squamous cell carcinoma (OPSCC) Radiotherapy (RT) Hypofractionation |
topic |
ddc 610 bkl 44.81 bkl 44.64 misc Equivalent uniform doses (EUD) misc Osteoradionecrosis (ORN) misc Oropharyngeal squamous cell carcinoma (OPSCC) misc Radiotherapy (RT) misc Hypofractionation |
topic_unstemmed |
ddc 610 bkl 44.81 bkl 44.64 misc Equivalent uniform doses (EUD) misc Osteoradionecrosis (ORN) misc Oropharyngeal squamous cell carcinoma (OPSCC) misc Radiotherapy (RT) misc Hypofractionation |
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ddc 610 bkl 44.81 bkl 44.64 misc Equivalent uniform doses (EUD) misc Osteoradionecrosis (ORN) misc Oropharyngeal squamous cell carcinoma (OPSCC) misc Radiotherapy (RT) misc Hypofractionation |
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Accounting for fractionation and heterogeneous dose distributions in the modelling of osteoradionecrosis in oropharyngeal carcinoma treatment |
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Accounting for fractionation and heterogeneous dose distributions in the modelling of osteoradionecrosis in oropharyngeal carcinoma treatment |
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Radiotherapy and oncology |
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Verduijn, Gerda M. Sijtsema, Nienke D. van Norden, Yvette Heemsbergen, Wilma D. Mast, Hetty Sewnaik, Aniel Chin, Denzel Baker, Sarah Capala, Marta E. van der Lugt, Aad van Meerten, Esther Hoogeman, Mischa S. Petit, Steven F. |
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Verduijn, Gerda M. |
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10.1016/j.radonc.2023.109889 |
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(ORCID)0000-0002-3513-6544 (ORCID)0000-0001-7928-1578 (ORCID)0000-0003-2144-0729 (ORCID)0000-0003-0559-543X (ORCID)0000-0002-4264-9903 (ORCID)0000-0001-9787-8239 |
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accounting for fractionation and heterogeneous dose distributions in the modelling of osteoradionecrosis in oropharyngeal carcinoma treatment |
title_auth |
Accounting for fractionation and heterogeneous dose distributions in the modelling of osteoradionecrosis in oropharyngeal carcinoma treatment |
abstract |
Background and purpose: Osteoradionecrosis (ORN) of the mandible is a severe complication following radiotherapy (RT). With a renewed interest in hypofractionation for head and neck radiotherapy, more information concerning ORN development after high fraction doses is important. The aim of this explorative study was to develop a model for ORN risk prediction applicable across different fractionation schemes using Equivalent Uniform Doses (EUD).Material and methods: We performed a retrospective cohort study in 334 oropharyngeal squamous cell carcinoma (OPSCC) patients treated with either a hypofractionated Stereotactic Body Radiation Therapy (HF-SBRT) boost or conventional Intensity Modulated Radiation Therapy (IMRT). ORN was scored with the CTCAE v5.0. HF-SBRT and IMRT dose distributions were converted into equivalent dose in 2 Gy fractions (α/β = 0.85 Gy) and analyzed using EUD. The parameter a that led to an EUD that best discriminated patients with and without grade ≥ 2 ORN was selected. Patient and treatment-related risk factors of ORN were analyzed with uni- and multivariable regression analysis.Results: A total of 32 patients (9.6%) developed ORN grade ≥ 2. An EUD(a = 8) best discriminated between ORN and non-ORN (AUC = 0.71). In multivariable regression, pre-RT extractions (SHR = 2.34; p = 0.012), mandibular volume (SHR = 1.04; p = 0.003), and the EUD(a = 8) (SHR = 1.14; p < 0.001) were significantly associated with ORN.Conclusion: Risk models for ORN based on conventional DVH parameters cannot be directly applied to HF-SBRT fractionation schemes and dose distributions. However, after correcting for fractionation and non-uniform dose distributions using EUD, a single model can distinguish between ORN and non-ORN after conventionally fractionated radiotherapy and hypofractionated boost treatments. |
abstractGer |
Background and purpose: Osteoradionecrosis (ORN) of the mandible is a severe complication following radiotherapy (RT). With a renewed interest in hypofractionation for head and neck radiotherapy, more information concerning ORN development after high fraction doses is important. The aim of this explorative study was to develop a model for ORN risk prediction applicable across different fractionation schemes using Equivalent Uniform Doses (EUD).Material and methods: We performed a retrospective cohort study in 334 oropharyngeal squamous cell carcinoma (OPSCC) patients treated with either a hypofractionated Stereotactic Body Radiation Therapy (HF-SBRT) boost or conventional Intensity Modulated Radiation Therapy (IMRT). ORN was scored with the CTCAE v5.0. HF-SBRT and IMRT dose distributions were converted into equivalent dose in 2 Gy fractions (α/β = 0.85 Gy) and analyzed using EUD. The parameter a that led to an EUD that best discriminated patients with and without grade ≥ 2 ORN was selected. Patient and treatment-related risk factors of ORN were analyzed with uni- and multivariable regression analysis.Results: A total of 32 patients (9.6%) developed ORN grade ≥ 2. An EUD(a = 8) best discriminated between ORN and non-ORN (AUC = 0.71). In multivariable regression, pre-RT extractions (SHR = 2.34; p = 0.012), mandibular volume (SHR = 1.04; p = 0.003), and the EUD(a = 8) (SHR = 1.14; p < 0.001) were significantly associated with ORN.Conclusion: Risk models for ORN based on conventional DVH parameters cannot be directly applied to HF-SBRT fractionation schemes and dose distributions. However, after correcting for fractionation and non-uniform dose distributions using EUD, a single model can distinguish between ORN and non-ORN after conventionally fractionated radiotherapy and hypofractionated boost treatments. |
abstract_unstemmed |
Background and purpose: Osteoradionecrosis (ORN) of the mandible is a severe complication following radiotherapy (RT). With a renewed interest in hypofractionation for head and neck radiotherapy, more information concerning ORN development after high fraction doses is important. The aim of this explorative study was to develop a model for ORN risk prediction applicable across different fractionation schemes using Equivalent Uniform Doses (EUD).Material and methods: We performed a retrospective cohort study in 334 oropharyngeal squamous cell carcinoma (OPSCC) patients treated with either a hypofractionated Stereotactic Body Radiation Therapy (HF-SBRT) boost or conventional Intensity Modulated Radiation Therapy (IMRT). ORN was scored with the CTCAE v5.0. HF-SBRT and IMRT dose distributions were converted into equivalent dose in 2 Gy fractions (α/β = 0.85 Gy) and analyzed using EUD. The parameter a that led to an EUD that best discriminated patients with and without grade ≥ 2 ORN was selected. Patient and treatment-related risk factors of ORN were analyzed with uni- and multivariable regression analysis.Results: A total of 32 patients (9.6%) developed ORN grade ≥ 2. An EUD(a = 8) best discriminated between ORN and non-ORN (AUC = 0.71). In multivariable regression, pre-RT extractions (SHR = 2.34; p = 0.012), mandibular volume (SHR = 1.04; p = 0.003), and the EUD(a = 8) (SHR = 1.14; p < 0.001) were significantly associated with ORN.Conclusion: Risk models for ORN based on conventional DVH parameters cannot be directly applied to HF-SBRT fractionation schemes and dose distributions. However, after correcting for fractionation and non-uniform dose distributions using EUD, a single model can distinguish between ORN and non-ORN after conventionally fractionated radiotherapy and hypofractionated boost treatments. |
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title_short |
Accounting for fractionation and heterogeneous dose distributions in the modelling of osteoradionecrosis in oropharyngeal carcinoma treatment |
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Sijtsema, Nienke D. van Norden, Yvette Heemsbergen, Wilma D. Mast, Hetty Sewnaik, Aniel Chin, Denzel Baker, Sarah Capala, Marta E. van der Lugt, Aad van Meerten, Esther Hoogeman, Mischa S. Petit, Steven F. |
author2Str |
Sijtsema, Nienke D. van Norden, Yvette Heemsbergen, Wilma D. Mast, Hetty Sewnaik, Aniel Chin, Denzel Baker, Sarah Capala, Marta E. van der Lugt, Aad van Meerten, Esther Hoogeman, Mischa S. Petit, Steven F. |
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306710110 |
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doi_str |
10.1016/j.radonc.2023.109889 |
up_date |
2024-07-06T22:16:42.684Z |
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