Dosimetric impact of weight loss and anatomical changes at organs at risk during intensity-modulated radiotherapy for head-and-neck cancer

Radaideh, Khaldoon M.

doi:10.1080/16878507.2020.1731125

Cited by 5 publications

(5 citation statements)

References 37 publications

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“…Loss of skeletal muscle is commonly observed in EC patients after chemoradiotherapy and has been reported as a poor prognostic factor [ 39 , 40 , 41 , 42 ]. Moreover, BWL might cause anatomical changes, increase setup error, and alter the dose distribution of radiotherapy [ 43 , 44 ]. All these problems could increase treatment toxicities and reduce accuracy.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Weight Loss during Chemoradiotherapy for Unresectable Esophageal Cancer: Real-World Results

Huang

Chou

Lin

et al. 2022

Life

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Weight loss is a common phenomenon presented in unresectable esophageal cancer (EC) patients during their definitive chemoradiotherapy (dCRT) treatment course. This study explored the prognostic value of weight changes during dCRT in unresectable EC patients. From 2009 to 2017, 69 cT4b thoracic EC patients undergoing complete curative dCRT without baseline malnutrition were included. Clinical factors were analyzed via the Cox proportional hazards model and survival was analyzed by the Kaplan–Meier method. During dCRT, the median weight loss percentage was 5.51% (IQR = 2.77–8.85%), and the lowest body weight was reached at 35 days (IQR = 23–43 days). Median OS of these patients was 13.5 months. Both univariate and multivariate analysis demonstrated that weight loss ≤ 4% during dCRT was significantly associated with superior OS with a hazard ratio of 2.61 (95% CI: 1.40–4.85, p = 0.002). The median OS for patients with weight loss ≤ 4% and >4% during dCRT was 59.6 months and 9.7 months, respectively (p = 0.001). Our study demonstrated that weight loss ≤ 4% during dCRT course is a favorable prognostic factor for cT4b EC patients. This index could serve as a nutrition support reference for unresectable EC patients receiving dCRT in the future.

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Section: Discussionmentioning

confidence: 99%

The Impact of Weight Loss during Chemoradiotherapy for Unresectable Esophageal Cancer: Real-World Results

Huang

Chou

Lin

et al. 2022

Life

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“…The Supplementary material describes two additional cases illustrating challenges in adaptive radiotherapy; consistent delineation of organs at risk (patient 2) and dosimetric effect of alterations in body outline (patient 3). Previous studies have found that outline variations have large dosimetric impact for radiation of cervical cancer and head and neck cancer, partly related to weight loss [28] , [29] . We therefore underline the importance of supportive treatment to maintain stable weight and of re-calculating doses to target and risk organs if there are visible changes with uncertain clinical effect.…”

Section: Discussionmentioning

confidence: 99%

Improved adaptive radiotherapy to adjust for anatomical alterations during curative treatment for locally advanced lung cancer

Bjaanæs

Sande

Loe

et al. 2021

Physics and Imaging in Radiation Oncology

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Anatomical changes during chemoradiation for lung cancer may decrease dose to the target or increase dose to organs at risk. To assess our ability to identify clinically significant anatomical alterations, we followed 67 lung cancer patients by daily cone-beam CT scans to ensure correct patient positioning and observe anatomical alterations. We also re-calculated the original dose distribution on a planned control CT scan obtained halfway during the treatment course to identify anatomical changes that potentially affected doses to the target or organs at risk. Of 66 patients who completed the treatment, 12 patients needed adaptation, two patients were adapted twice. We conclude that daily cone-beam CT and routines at the treatment machine discover relevant anatomical changes during curative radiotherapy for patients with lung cancer without additional imaging.

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“…These anatomical changes make the initial treatment plan obsolete; eventually, the treatment demands another FBCT for replanning. 1,2 However, obtaining high-resolution FBCT images is time-consuming and may result in significant exposure to ionising radiation. If the onboard CBCT taken during radiotherapy can be used for replanning rather than taking another FBCT, the patients can effectively reduce medical expenses and radiation exposure.…”

Section: Introductionmentioning

confidence: 99%

“…During the course of fractionated therapy, the body can undergo changes such as weight loss, organ shrinkage, contour changes, or organ movement. These anatomical changes make the initial treatment plan obsolete; eventually, the treatment demands another FBCT for replanning 1,2 . However, obtaining high‐resolution FBCT images is time‐consuming and may result in significant exposure to ionising radiation.…”

Section: Introductionmentioning

confidence: 99%

Cone beam computed tomography enhancement using feature‐embedded variational autoencoder with a perceptual loss function

Joseph

Singh

Pournami

et al. 2023

Int J Imaging Syst Tech

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Image‐Guided Radiation Therapy (IGRT) is a cancer treatment method. IGRT usually follows a fragmented treatment track. The weight loss of a patient causes the first treatment plan to be flawed. Medical experts can avert retaking Fan Beam Computed Tomography (FBCT) images before each session of the therapy if the Cone Beam Computed Tomography (CBCT), which is mounted on a Medical Linear Accelerator (LINAC), gives high‐quality images. Rather than improvising the CBCT machine, deep‐learning techniques can be used to enhance the CBCT images. This paper proposes a Feature‐Embedded Variational AutoEncoder (FE‐VAE) for CBCT image enhancement. A feature embedding is incorporated using a MultiResUNet‐based feature extractor to preserve structural information in the input image. A perceptual loss function, which is the product of Mean Absolute Error (MAE) and inverse Structural Similarity Index Measure (SSIM), is proposed in this work. The model is trained using Head‐and‐Neck (H&N) CBCT‐FBCT pairs of 59 cancer patients. Our proposed architecture successfully generates images much closer to the ground truth FBCT images. The model gives an average peak signal‐to‐noise ratio of 32.89 dB, mean squared error of 297.36, MAE of 32.37 HU, and SSIM of 0.99. The trained model gave the least deviated SSIM and MAE, implying that the model is well‐optimised. The experimentation with different losses proves the prominence of the proposed loss function. The visual quality of the results obtained is also comparable with the ground truth. The results indicate that the model produces enhanced CBCT images. Hence, the proposed FE‐VAE is useful in fractionated radiotherapy to minimise the number of scanning sessions for replanning the dosimetry.

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Dosimetric impact of weight loss and anatomical changes at organs at risk during intensity-modulated radiotherapy for head-and-neck cancer

Abstract: To cite this article: Khaldoon M. Radaideh (2020) Dosimetric impact of weight loss and anatomical changes at organs at risk during intensity-modulated radiotherapy for head-andneck cancer,

Cited by 5 publications

References 37 publications

The Impact of Weight Loss during Chemoradiotherapy for Unresectable Esophageal Cancer: Real-World Results

The Impact of Weight Loss during Chemoradiotherapy for Unresectable Esophageal Cancer: Real-World Results

Improved adaptive radiotherapy to adjust for anatomical alterations during curative treatment for locally advanced lung cancer

Cone beam computed tomography enhancement using feature‐embedded variational autoencoder with a perceptual loss function

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