Evaluation of Target Volume Location and Its Impact on Delivered Dose Using Cone-Beam Computed Tomography Scans for Patients with Head and Neck Cancer

Grover, Devyn; Laraque, Malcolm; Debenham, Brock

doi:10.1016/j.jmir.2019.03.181

Cited by 1 publication

(1 citation statement)

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“…Based on the available literature and our findings, we recommend that one should try to minimise the radiation dose on the cochlea as much as possible to avoid hearing loss and keep the dose on the cochlea at least below 20 Gy if possible. Currently used radiotherapy techniques such as Volumetric-Modulated Arc Therapy (VMAT) [ 45 , 46 ], Cone-beam computed tomography [ 47 ], and improved radiotherapy masks [ 48 ] can reduce inaccuracies and prevent the unnecessary irradiation of organs at risk, for example, the cochlea.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Hearing Loss in Irradiated Survivors of Head and Neck Rhabdomyosarcoma

Diepstraten

Wiersma

Schoot

et al. 2022

Cancers

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Purpose: The frequency and patterns of HL in a HNRMS survivor cohort were investigated. A dose–effect relationship between the dose to the cochlea and HL was explored. Methods: Dutch survivors treated for HNRMS between 1993 and 2017 with no relapse and at least two years after the end of treatment were eligible for inclusion. The survivors were evaluated for HL with pure-tone audiometry. HL was graded according to the Muenster, Common Terminology Criteria for Adverse Events (CTCAE) v4.03 and International Society for Paediatric Oncology (SIOP) classification. We defined deleterious HL as Muenster ≥ 2b, CTCAE ≥ 2, and SIOP ≥ 2. Mixed-effects logistic regression was used to search for the dose–effect relationship between the irradiation dose to the cochlea and the occurrence of HL. Results: Forty-two HNRMS survivors underwent pure-tone audiometry. The Muenster, CTCAE and SIOP classification showed that 19.0% (n = 8), 14.2% (n = 6) and 11.9% (n = 5) of survivors suffered from HL, respectively. A low-frequency HL pattern with normal hearing or milder hearing loss in the higher frequencies was seen in four survivors. The maximum cochlear irradiation dose was significantly associated with HL (≥Muenster 2b) (p = 0.047). In our series, HL (≥Muenster 2b) was especially observed when the maximum dose to the cochlea exceeded 19 Gy. Conclusion: HL occurred in up to 19% of survivors of HNRMS. More research is needed on HL patterns in HNRMS survivors and on radiotherapy dose–effect relationships.

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Section: Discussionmentioning

confidence: 99%