Thyroid-optimized and thyroid-sparing radiotherapy in oral cavity and oropharyngeal carcinoma: A dosimetric study
Background: Radiation-induced hypothyroidism is a common toxicity of head and neck radiation. Our re-planning study aimed to reduce thyroid dose while maintaining target coverage with IMRT. Methods: We retrospectively identified patients with oral-cavity (n = 5) and oropharyngeal cancer (n = 5). Tre...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-12-01
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| Series: | Technical Innovations & Patient Support in Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405632421000378 |
| _version_ | 1818873833357049856 |
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| author | Anna K. Wu Nicholas J. Damico Erin Healy Michael Z. Kharouta Ghazal Khandel Alok Deshane Jennifer Sipos Jacob Eckstein Wesley Zoller Ashlee Ewing Stella Ling Jessica Wobb Darrion Mitchell John Grecula Sachin Jhawar Eric Miller Mauricio Gamez Virginia Diavolitsis Dukagjin Blakaj Aashish D. Bhatt |
| author_facet | Anna K. Wu Nicholas J. Damico Erin Healy Michael Z. Kharouta Ghazal Khandel Alok Deshane Jennifer Sipos Jacob Eckstein Wesley Zoller Ashlee Ewing Stella Ling Jessica Wobb Darrion Mitchell John Grecula Sachin Jhawar Eric Miller Mauricio Gamez Virginia Diavolitsis Dukagjin Blakaj Aashish D. Bhatt |
| author_sort | Anna K. Wu |
| collection | DOAJ |
| description | Background: Radiation-induced hypothyroidism is a common toxicity of head and neck radiation. Our re-planning study aimed to reduce thyroid dose while maintaining target coverage with IMRT. Methods: We retrospectively identified patients with oral-cavity (n = 5) and oropharyngeal cancer (n = 5). Treatment plans were re-optimized with 45 Gy thyroid mean dose constraint, then we cropped the thyroid out of PTVs and further reduced thyroid dose. Target coverage was delivering 100% dose to ≥ 93% of PTV and 95% of dose to > 99% of PTV. Results: Originally, average mean dose to thyroid was 5580 cGy. In model I, this dropped to 4325 cGy (p < 0.0001). In model II, average mean dose was reduced to 3154 cGy (p < 0.0001). For PTV low and PTV int, all had acceptable target coverage. Conclusion: In patients with oral-cavity and oropharyngeal cancers, mean dose could be significantly reduced using a thyroid-optimized or thyroid-sparing IMRT technique with adequate coverage. |
| first_indexed | 2024-12-19T13:00:59Z |
| format | Article |
| id | doaj.art-e998ffaacd7049b1bfe570174d3d095a |
| institution | Directory Open Access Journal |
| issn | 2405-6324 |
| language | English |
| last_indexed | 2024-12-19T13:00:59Z |
| publishDate | 2021-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Technical Innovations & Patient Support in Radiation Oncology |
| spelling | doaj.art-e998ffaacd7049b1bfe570174d3d095a2022-12-21T20:20:15ZengElsevierTechnical Innovations & Patient Support in Radiation Oncology2405-63242021-12-01202834Thyroid-optimized and thyroid-sparing radiotherapy in oral cavity and oropharyngeal carcinoma: A dosimetric studyAnna K. Wu0Nicholas J. Damico1Erin Healy2Michael Z. Kharouta3Ghazal Khandel4Alok Deshane5Jennifer Sipos6Jacob Eckstein7Wesley Zoller8Ashlee Ewing9Stella Ling10Jessica Wobb11Darrion Mitchell12John Grecula13Sachin Jhawar14Eric Miller15Mauricio Gamez16Virginia Diavolitsis17Dukagjin Blakaj18Aashish D. Bhatt19Case Western Reserve University School of Medicine, Cleveland, OH, USADepartment of Radiation Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, USADepartment of Radiation Oncology, Ohio State University, Columbus, OH, USADepartment of Radiation Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, USADepartment of Radiation Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, USACase Western Reserve University School of Medicine, Cleveland, OH, USADepartment of Endocrinology, Ohio State University, Columbus, OH, USADepartment of Radiation Oncology, Ohio State University, Columbus, OH, USADepartment of Radiation Oncology, Ohio State University, Columbus, OH, USADepartment of Radiation Oncology, Ohio State University, Columbus, OH, USADepartment of Radiation Oncology, Ohio State University, Columbus, OH, USADepartment of Radiation Oncology, Ohio State University, Columbus, OH, USADepartment of Radiation Oncology, Ohio State University, Columbus, OH, USADepartment of Radiation Oncology, Ohio State University, Columbus, OH, USADepartment of Radiation Oncology, Ohio State University, Columbus, OH, USADepartment of Radiation Oncology, Ohio State University, Columbus, OH, USADepartment of Radiation Oncology, Ohio State University, Columbus, OH, USADepartment of Radiation Oncology, Ohio State University, Columbus, OH, USADepartment of Radiation Oncology, Ohio State University, Columbus, OH, USADepartment of Radiation Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, USA; Corresponding author at: Department of Radiation Oncology, University Hospitals, Seidman Cancer Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.Background: Radiation-induced hypothyroidism is a common toxicity of head and neck radiation. Our re-planning study aimed to reduce thyroid dose while maintaining target coverage with IMRT. Methods: We retrospectively identified patients with oral-cavity (n = 5) and oropharyngeal cancer (n = 5). Treatment plans were re-optimized with 45 Gy thyroid mean dose constraint, then we cropped the thyroid out of PTVs and further reduced thyroid dose. Target coverage was delivering 100% dose to ≥ 93% of PTV and 95% of dose to > 99% of PTV. Results: Originally, average mean dose to thyroid was 5580 cGy. In model I, this dropped to 4325 cGy (p < 0.0001). In model II, average mean dose was reduced to 3154 cGy (p < 0.0001). For PTV low and PTV int, all had acceptable target coverage. Conclusion: In patients with oral-cavity and oropharyngeal cancers, mean dose could be significantly reduced using a thyroid-optimized or thyroid-sparing IMRT technique with adequate coverage.http://www.sciencedirect.com/science/article/pii/S2405632421000378Intensity-modulated radiotherapyRadiation toxicityHypothyroidismThyroid-optimizedThyroid-sparing |
| spellingShingle | Anna K. Wu Nicholas J. Damico Erin Healy Michael Z. Kharouta Ghazal Khandel Alok Deshane Jennifer Sipos Jacob Eckstein Wesley Zoller Ashlee Ewing Stella Ling Jessica Wobb Darrion Mitchell John Grecula Sachin Jhawar Eric Miller Mauricio Gamez Virginia Diavolitsis Dukagjin Blakaj Aashish D. Bhatt Thyroid-optimized and thyroid-sparing radiotherapy in oral cavity and oropharyngeal carcinoma: A dosimetric study Technical Innovations & Patient Support in Radiation Oncology Intensity-modulated radiotherapy Radiation toxicity Hypothyroidism Thyroid-optimized Thyroid-sparing |
| title | Thyroid-optimized and thyroid-sparing radiotherapy in oral cavity and oropharyngeal carcinoma: A dosimetric study |
| title_full | Thyroid-optimized and thyroid-sparing radiotherapy in oral cavity and oropharyngeal carcinoma: A dosimetric study |
| title_fullStr | Thyroid-optimized and thyroid-sparing radiotherapy in oral cavity and oropharyngeal carcinoma: A dosimetric study |
| title_full_unstemmed | Thyroid-optimized and thyroid-sparing radiotherapy in oral cavity and oropharyngeal carcinoma: A dosimetric study |
| title_short | Thyroid-optimized and thyroid-sparing radiotherapy in oral cavity and oropharyngeal carcinoma: A dosimetric study |
| title_sort | thyroid optimized and thyroid sparing radiotherapy in oral cavity and oropharyngeal carcinoma a dosimetric study |
| topic | Intensity-modulated radiotherapy Radiation toxicity Hypothyroidism Thyroid-optimized Thyroid-sparing |
| url | http://www.sciencedirect.com/science/article/pii/S2405632421000378 |
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