Development of Normal Tissue Complication Probability Model for Trismus in Head and Neck Cancer Patients Treated With Radiotherapy: The Role of Dosimetric and Clinical Factors

Abstract

following eligibility criteria: 1) HNC originating in the oral cavity, nasopharynx, oropharynx, hypopharynx, or larynx; 2) treated with definitive RT either alone or in combination with chemotherapy or cetuximab; 3) no previous surgery, RT and/or chemotherapy; 4) no previous malignancies; 5) no distant metastases; 6) planningcomputed tomography (CT) and three-dimensional dose distributions available prior to and 6 months after completion of (CH)RT; 7) no efforts of reducing dose in potential organs at risks (OARs) for trismus; 8) alive with no recurrences 6 months after RT, and: 9) no rehabilitation or medication for trismus. The study population used for this analysis was composed of 132 patients who fulfilled all these eligibility criteria. The majority of the patients were male (77%) and the mean age of the study population was 62 years, ranging from 33 to 89 years. The number of the patients treated with concurrent systemic therapy was 40 (30%). The demographic and tumor characteristics of this study population are listed in Table I.

Comparison of Conventional Fractionation and Accelerated Fractionation With Concomitant Boost for Radiotherapy of Non-metastatic Stage IV Head-and-Neck Cancer

“…Since outcome of patients with locally advanced SCCHN require improvement, many preclinical and clinical studies have been conducted during recent years (17)(18)(19)(20)(21)(22). The prognoses of patients with SCCHN are particularly poor, if unresectable or incompletely resected.…”

NTCP Modeling of Late Effects for Head and Neck Cancer: A Systematic Review

“…Furthermore, the biological dose of OARs might be different according to the corresponding alpha/beta ratio, which might translate to a different toxicity development; for example, in the case of hypofractionated/accelerated radiotherapy treatment schedules. Current NTCP models are not designed to include altered fractionation, nevertheless some studies investigated the fractionation effect [ 31 , 39 , 54 ] ( Supplemental Table ), whereas others did not [ 38 ]. Other studies showed the potential of improving NTCP models with the addition of baseline imaging biomarkers [ 33 , 55 , 56 ], which represent patient-specific tissue characteristics.…”

The role of Photobiomodulation therapy in the treatment of head and neck radiotherapy-related trismus: a single-arm clinical trial

“…DVH (Dose Volume Histogram) was used to delimitation of these structures was drawn on the planning computerized tomography scan in axial sections of 2mm every two sections. After delimitation of the anatomical structures, we calculated the minimum, average, and maximum radiation doses received by these structures [19].…”