PMID- 37256301
OWN - NLM
STAT- MEDLINE
DCOM- 20231023
LR  - 20231107
IS  - 1439-099X (Electronic)
IS  - 0179-7158 (Linking)
VI  - 199
IP  - 10
DP  - 2023 Oct
TI  - Predictors of toxicity after curative reirradiation with intensity modulated 
      radiotherapy or proton therapy for recurrent head and neck carcinoma: new dose 
      constraints for pharyngeal constrictors muscles and oral cavity.
PG  - 901-909
LID - 10.1007/s00066-023-02080-y [doi]
AB  - BACKGROUND: Our study aims to identify predictive factors of moderate to severe 
      (grade >/= 2) late toxicity after reirradiation (reRT) of recurrent head and neck 
      carcinoma (HNC) and explore the correlations between dose organs at risk (OAR) 
      and grade >/= 2 toxicity. MATERIAL AND METHODS: Between 09/2007 and 09/2019, 
      55 patients were re-irradiated with IMRT or proton therapy with curative intent 
      for advanced HNC. Our study included all patients for whom data from the first 
      and second irradiations were available. Co-variables, including interval to reRT, 
      size of re-irradiated PTV, and dose to OAR, were analyzed as potential predictors 
      for developing moderate to severe long-term toxicity with death as a competing 
      risk. Receiver-operator characteristics (ROC) analysis assessed the association 
      between dose/volume parameters and the risk of toxicity. RESULTS: Twenty-three 
      patients participated in our study. After a median follow-up of 41 months, 65% of 
      the patients experienced grade >/= 2 late toxicity. The average dose to pharyngeal 
      constrictor muscles (PCM) at the time of reRT showed an association with the risk 
      of grade >/= 2 dysphagia: AUC = 0.78 (95% CI: 0.53-1), optimal cut-off 
      value = 36.7 Gy (sensitivity 62%/specificity 100%). The average dose to the oral 
      cavity at the time of reRT showed an association with the risk of grade 
      >/= 2 dysgeusia: AUC = 0.96 (0.89-1), optimal cut-off value = 20.5 Gy (sensitivity 
      100%/specificity 88%). CONCLUSION: Our analysis depicted an association between 
      the dose to OAR and the risk of developing moderate to severe dysphagia and 
      dysgeusia and proposed new dose constraints for PCM (36.7 Gy) and oral cavity 
      (20.5 Gy).
CI  - (c) 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
FAU - Beddok, Arnaud
AU  - Beddok A
AUID- ORCID: 0000-0002-5512-4161
AD  - Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue 
      d'Ulm, 75005, Paris/Orsay, France. a.beddok@gmail.com.
AD  - Institut Curie, PSL Research University, University Paris Saclay, Inserm LITO, 
      91898, Orsay, France. a.beddok@gmail.com.
FAU - Maynadier, Xavier
AU  - Maynadier X
AD  - Biometry Unit, Institut Curie, PSL Research University, Paris, France.
FAU - Krhili, Samar
AU  - Krhili S
AD  - Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue 
      d'Ulm, 75005, Paris/Orsay, France.
FAU - Ala Eddine, Catherine
AU  - Ala Eddine C
AD  - Department of Radiology, Institut Curie, Paris, France.
FAU - Champion, Laurence
AU  - Champion L
AD  - Institut Curie, PSL Research University, University Paris Saclay, Inserm LITO, 
      91898, Orsay, France.
AD  - Department of Nuclear Medicine, Institut Curie, Saint-Cloud, France.
FAU - Chilles, Anne
AU  - Chilles A
AD  - Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue 
      d'Ulm, 75005, Paris/Orsay, France.
FAU - Goudjil, Farid
AU  - Goudjil F
AD  - Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue 
      d'Ulm, 75005, Paris/Orsay, France.
FAU - Zefkili, Sofia
AU  - Zefkili S
AD  - Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue 
      d'Ulm, 75005, Paris/Orsay, France.
FAU - Amessis, Malika
AU  - Amessis M
AD  - Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue 
      d'Ulm, 75005, Paris/Orsay, France.
FAU - Choussy, Olivier
AU  - Choussy O
AD  - Department of Head and Neck Surgery, Institut Curie, Paris, France.
FAU - Le Tourneau, Christophe
AU  - Le Tourneau C
AD  - Department of Drug Development and Innovation (D3i), INSERM U900 Research unit, 
      Paris-Saclay University, Institut Curie, Paris, France.
FAU - Buvat, Irene
AU  - Buvat I
AD  - Institut Curie, PSL Research University, University Paris Saclay, Inserm LITO, 
      91898, Orsay, France.
FAU - Crehange, Gilles
AU  - Crehange G
AD  - Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue 
      d'Ulm, 75005, Paris/Orsay, France.
AD  - Institut Curie, PSL Research University, University Paris Saclay, Inserm LITO, 
      91898, Orsay, France.
FAU - Carton, Matthieu
AU  - Carton M
AD  - Biometry Unit, Institut Curie, PSL Research University, Paris, France.
FAU - Calugaru, Valentin
AU  - Calugaru V
AD  - Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue 
      d'Ulm, 75005, Paris/Orsay, France.
LA  - eng
PT  - Journal Article
DEP - 20230531
PL  - Germany
TA  - Strahlenther Onkol
JT  - Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et 
      al]
JID - 8603469
SB  - IM
MH  - Humans
MH  - *Radiotherapy, Intensity-Modulated/adverse effects
MH  - *Re-Irradiation/adverse effects
MH  - *Proton Therapy/adverse effects
MH  - Dysgeusia
MH  - *Deglutition Disorders/etiology
MH  - *Head and Neck Neoplasms/radiotherapy
MH  - *Carcinoma/radiotherapy
MH  - Mouth
MH  - Muscles
MH  - Radiotherapy Dosage
MH  - Neoplasm Recurrence, Local/radiotherapy
OTO - NOTNLM
OT  - Head and neck carcinoma
OT  - IMRT
OT  - Proton therapy
OT  - Reirradiation
OT  - Toxicity
EDAT- 2023/05/31 13:12
MHDA- 2023/10/23 12:44
CRDT- 2023/05/31 11:03
PHST- 2022/12/16 00:00 [received]
PHST- 2023/03/26 00:00 [accepted]
PHST- 2023/10/23 12:44 [medline]
PHST- 2023/05/31 13:12 [pubmed]
PHST- 2023/05/31 11:03 [entrez]
AID - 10.1007/s00066-023-02080-y [pii]
AID - 10.1007/s00066-023-02080-y [doi]
PST - ppublish
SO  - Strahlenther Onkol. 2023 Oct;199(10):901-909. doi: 10.1007/s00066-023-02080-y. 
      Epub 2023 May 31.