Risk of temporal lobe necrosis between proton beam and volumetric modulated arc therapies in patients with different head and neck cancers
Abstract Background To investigate the frequency of temporal lobe necrosis (TLN) soon after radiotherapy (RT) and identify differences among patients with various types of head and neck cancer (HNC) and between different RT methods. Methods We retrospectively reviewed 483 patients with HNC who had c...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13014-023-02344-y |
| _version_ | 1797451907927638016 |
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| author | Chi-Hung Liu Chien-Yu Lin Bing-Shen Huang Yi-Chia Wei Ting-Yu Chang Chih-Hua Yeh Pi-Shan Sung Jian-Lin Jiang Li-Ying Lin Joseph Tung-Chieh Chang Kang-Hsing Fan |
| author_facet | Chi-Hung Liu Chien-Yu Lin Bing-Shen Huang Yi-Chia Wei Ting-Yu Chang Chih-Hua Yeh Pi-Shan Sung Jian-Lin Jiang Li-Ying Lin Joseph Tung-Chieh Chang Kang-Hsing Fan |
| author_sort | Chi-Hung Liu |
| collection | DOAJ |
| description | Abstract Background To investigate the frequency of temporal lobe necrosis (TLN) soon after radiotherapy (RT) and identify differences among patients with various types of head and neck cancer (HNC) and between different RT methods. Methods We retrospectively reviewed 483 patients with HNC who had completed RT in our hospital after January, 2015. These patients were followed-up at the radio-oncology department and received contrast-enhanced magnetic resonance imaging (MRI) or computed tomography (CT) to identify metastases or recurrence of cancer at regular intervals. Meanwhile, the occurrence of TLN, graded according to the Common Terminology Criteria for Adverse Events V5.0, was recorded. We categorized the patients into nasopharyngeal carcinoma (NPC) and non-NPC groups and compared the cumulative occurrence of TLN between the groups using Kaplan–Meier and Cox regression analyses. We further compared the cumulative occurrence of TLN between proton beam therapy (PBT) and volumetric modulated arc therapy (VMAT) in patients with any HNC, NPC, and non-NPC HNC. Results Compared with the non-NPC group, the NPC group had a higher frequency of TLN (5.6% vs. 0.4%, p < 0.01) and were more commonly associated with TLN in the Kaplan–Meier analysis (p < 0.01) and the Cox regression model after covariates were adjusted for (adjusted hazard ratio: 13.35, 95% confidence interval: 1.37–130.61) during the follow-up period. Furthermore, the frequency of TLN was similar between patients receiving PBT and those receiving VMAT (PBT vs. VMAT: 4.7% vs. 6.3%, p = 0.76). Kaplan–Meier analysis revealed that the accumulated risks of TLN were similar between PBT and VMAT in patients with any HNC (p = 0.44), NPC (p = 0.84), and non-NPC HNC (p = 0.70). Conclusion Our study demonstrated that patients with NPC are susceptible to TLN during the early period after RT. In addition, PBT may be associated with an equivalent risk of TLN when compared with VMAT in patients with NPC or other HNCs. |
| first_indexed | 2024-03-09T15:01:13Z |
| format | Article |
| id | doaj.art-a8531310832d4b309386f1691de40a3e |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-03-09T15:01:13Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-a8531310832d4b309386f1691de40a3e2023-11-26T13:54:06ZengBMCRadiation Oncology1748-717X2023-09-0118111110.1186/s13014-023-02344-yRisk of temporal lobe necrosis between proton beam and volumetric modulated arc therapies in patients with different head and neck cancersChi-Hung Liu0Chien-Yu Lin1Bing-Shen Huang2Yi-Chia Wei3Ting-Yu Chang4Chih-Hua Yeh5Pi-Shan Sung6Jian-Lin Jiang7Li-Ying Lin8Joseph Tung-Chieh Chang9Kang-Hsing Fan10Stroke Center, Department of Neurology, Linkou Medical Center, Chang Gung Memorial HospitalSchool of Medicine, College of Medicine, Chang Gung UniversitySchool of Medicine, College of Medicine, Chang Gung UniversityDepartment of Neurology, Keelung Chang Gung Memorial HospitalStroke Center, Department of Neurology, Linkou Medical Center, Chang Gung Memorial HospitalSchool of Medicine, College of Medicine, Chang Gung UniversityDepartment of Neurology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung UniversityStroke Center, Department of Neurology, Linkou Medical Center, Chang Gung Memorial HospitalSchool of Medicine, College of Medicine, Chang Gung UniversitySchool of Medicine, College of Medicine, Chang Gung UniversitySchool of Medicine, College of Medicine, Chang Gung UniversityAbstract Background To investigate the frequency of temporal lobe necrosis (TLN) soon after radiotherapy (RT) and identify differences among patients with various types of head and neck cancer (HNC) and between different RT methods. Methods We retrospectively reviewed 483 patients with HNC who had completed RT in our hospital after January, 2015. These patients were followed-up at the radio-oncology department and received contrast-enhanced magnetic resonance imaging (MRI) or computed tomography (CT) to identify metastases or recurrence of cancer at regular intervals. Meanwhile, the occurrence of TLN, graded according to the Common Terminology Criteria for Adverse Events V5.0, was recorded. We categorized the patients into nasopharyngeal carcinoma (NPC) and non-NPC groups and compared the cumulative occurrence of TLN between the groups using Kaplan–Meier and Cox regression analyses. We further compared the cumulative occurrence of TLN between proton beam therapy (PBT) and volumetric modulated arc therapy (VMAT) in patients with any HNC, NPC, and non-NPC HNC. Results Compared with the non-NPC group, the NPC group had a higher frequency of TLN (5.6% vs. 0.4%, p < 0.01) and were more commonly associated with TLN in the Kaplan–Meier analysis (p < 0.01) and the Cox regression model after covariates were adjusted for (adjusted hazard ratio: 13.35, 95% confidence interval: 1.37–130.61) during the follow-up period. Furthermore, the frequency of TLN was similar between patients receiving PBT and those receiving VMAT (PBT vs. VMAT: 4.7% vs. 6.3%, p = 0.76). Kaplan–Meier analysis revealed that the accumulated risks of TLN were similar between PBT and VMAT in patients with any HNC (p = 0.44), NPC (p = 0.84), and non-NPC HNC (p = 0.70). Conclusion Our study demonstrated that patients with NPC are susceptible to TLN during the early period after RT. In addition, PBT may be associated with an equivalent risk of TLN when compared with VMAT in patients with NPC or other HNCs.https://doi.org/10.1186/s13014-023-02344-yTemporal lobe necrosisHead and neck cancerNasopharyngeal carcinomaRadiation therapyProton therapy |
| spellingShingle | Chi-Hung Liu Chien-Yu Lin Bing-Shen Huang Yi-Chia Wei Ting-Yu Chang Chih-Hua Yeh Pi-Shan Sung Jian-Lin Jiang Li-Ying Lin Joseph Tung-Chieh Chang Kang-Hsing Fan Risk of temporal lobe necrosis between proton beam and volumetric modulated arc therapies in patients with different head and neck cancers Radiation Oncology Temporal lobe necrosis Head and neck cancer Nasopharyngeal carcinoma Radiation therapy Proton therapy |
| title | Risk of temporal lobe necrosis between proton beam and volumetric modulated arc therapies in patients with different head and neck cancers |
| title_full | Risk of temporal lobe necrosis between proton beam and volumetric modulated arc therapies in patients with different head and neck cancers |
| title_fullStr | Risk of temporal lobe necrosis between proton beam and volumetric modulated arc therapies in patients with different head and neck cancers |
| title_full_unstemmed | Risk of temporal lobe necrosis between proton beam and volumetric modulated arc therapies in patients with different head and neck cancers |
| title_short | Risk of temporal lobe necrosis between proton beam and volumetric modulated arc therapies in patients with different head and neck cancers |
| title_sort | risk of temporal lobe necrosis between proton beam and volumetric modulated arc therapies in patients with different head and neck cancers |
| topic | Temporal lobe necrosis Head and neck cancer Nasopharyngeal carcinoma Radiation therapy Proton therapy |
| url | https://doi.org/10.1186/s13014-023-02344-y |
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