NTCP Modeling for High-Grade Temporal Radionecroses in a Large Cohort of Patients Receiving Pencil Beam Scanning Proton Therapy for Skull Base and Head and Neck Tumors

Schröder, Christina; Köthe, A.; Angelis, Claudio De; Basler, Lucas; Fattori, Giovanni; Safai, Sairos; Leiser, Dominic; Aj, Lomax; Weber, D.C.

doi:10.1016/j.ijrobp.2022.01.047

Cited by 3 publications

(6 citation statements)

References 32 publications

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“…In recent years, specific NTCP have been modeling for patient selection for proton therapy [ 22 , 24 ]. Schröder et al develop a NTCP model combining clinical and dosimetric factors focused on grade ≥ 2 radionecrosis in a large cohort of patients receiving proton, the best fit was found for the model containing age, prescription dose, D1cc (Gy), and hypertensive blood pressure as risk factors [ 25 ]. External validation will be the next step to improve generalizability and potential introduction into clinical routine.…”

Section: Discussionmentioning

confidence: 99%

Research trends of radiation induced temporal lobe injury in patients with nasopharyngeal carcinoma from 2000 to 2022: a bibliometric analysis

Guan,

Yu,

Liu

et al. 2023

Radiat Oncol

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Background In patients with nasopharyngeal cancer (NPC), radiation-induced temporal lobe injury (TLI) is the most dreaded late-stage complication following radiation therapy (RT). We currently lack a definitive algorithmic administration for this entity. In the meantime, the pathogenesis of TLI and the mechanism-based interventions to prevent or treat this adverse effect remain unknown. To better answer the aforementioned questions, it is necessary to comprehend the intellectual foundations and prospective trends of this field through bibliometric analysis. Methods Articles were gathered from the Web of Science Core Collection (WoSCC) database between 2000 and 2022. CiteSpace was utilized to create a country/institutional co-authorship network, perform dual-map analysis, and find keywords with citation bursts. VOSviewer was used to build networks based on author co-authorship, journal citation, co-citation analysis of authors, references, and journals, and keyword co-occurrence. Results A total of 140 articles and reviews were included in the final analysis. The number of publications has steadily increased with some fluctuations over the years. The country and institution contributing most to this field are the China and Sun Yat-Sen University. Han Fei was the most prolific author, while Lee Awm was the most frequently cited. The analysis of co-occurrence revealed three clusters, including: “radiation-induced injury or necrosis in NPC,” “clinical studies on chemotherapy/radiotherapy complications and survival in recurrent NPC,” and “IMRT/chemotherapy outcomes and toxicities in head and neck cancer”). Most recent keyword bursts were “volume,” “temporal lobe injury,” “toxicities,” “model,” “survival,” “intensity modulated radiotherapy,” “induced brain injury,” “head and neck cancer,” and “temporal lobe.” Conclusion This study provides some insights of the major areas of interest in the field of radiation-induced TLI in patients with NPC by bibliometric analyses. This study assists scholars in locating collaborators and significant literature in this field, provides guidance for publishing journals, and identifies research hotspots. This analysis acknowledges significant contributions to the discipline and encourages the scientific community to conduct additional research.

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Section: Discussionmentioning

confidence: 99%

Research trends of radiation induced temporal lobe injury in patients with nasopharyngeal carcinoma from 2000 to 2022: a bibliometric analysis

Guan,

Yu,

Liu

et al. 2023

Radiat Oncol

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“…should be more comparable. Shroeder and colleagues reported that D1cc is the most important dosimetry factor correlated to TLN [ 15 ]. The QUANTEC analysis also showed that maximal dose is predictive for TLN [ 24 ].…”

Section: Methodsmentioning

confidence: 99%

“…The accuracy achieved with PBT allows further widening of the therapeutic window, as dose escalation for radioresistant tumors is possible without jeopardizing treatment tolerance [ 10 ]. Comparative studies of PBT versus photon radiotherapy have demonstrated diverse results [ 11 – 15 ]. Some studies showed a lower regional toxicity in patients receiving PBT for various cancers [ 8 , 9 , 12 , 13 , 16 ], results corroborated by the biggest prospective PBT series published to date [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Some studies showed a lower regional toxicity in patients receiving PBT for various cancers [ 8 , 9 , 12 , 13 , 16 ], results corroborated by the biggest prospective PBT series published to date [ 12 , 13 ]. However, other studies focusing on HNC only demonstrated that the risk of TLN was higher in patients receiving PBT [ 14 , 15 ], which could be resulted from various biological and treatment uncertainties [ 16 ]. Studies mentioned above used different techniques treating different cancer around the brain, which were unable to answer the question.…”

Section: Introductionmentioning

confidence: 99%

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Risk of temporal lobe necrosis between proton beam and volumetric modulated arc therapies in patients with different head and neck cancers

Liu,

Lin,

Huang

et al. 2023

Radiat Oncol

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Background To investigate the frequency of temporal lobe necrosis (TLN) soon after radiotherapy (RT) and identify differences among patients with various types of head and neck cancer (HNC) and between different RT methods. Methods We retrospectively reviewed 483 patients with HNC who had completed RT in our hospital after January, 2015. These patients were followed-up at the radio-oncology department and received contrast-enhanced magnetic resonance imaging (MRI) or computed tomography (CT) to identify metastases or recurrence of cancer at regular intervals. Meanwhile, the occurrence of TLN, graded according to the Common Terminology Criteria for Adverse Events V5.0, was recorded. We categorized the patients into nasopharyngeal carcinoma (NPC) and non-NPC groups and compared the cumulative occurrence of TLN between the groups using Kaplan–Meier and Cox regression analyses. We further compared the cumulative occurrence of TLN between proton beam therapy (PBT) and volumetric modulated arc therapy (VMAT) in patients with any HNC, NPC, and non-NPC HNC. Results Compared with the non-NPC group, the NPC group had a higher frequency of TLN (5.6% vs. 0.4%, p < 0.01) and were more commonly associated with TLN in the Kaplan–Meier analysis (p < 0.01) and the Cox regression model after covariates were adjusted for (adjusted hazard ratio: 13.35, 95% confidence interval: 1.37–130.61) during the follow-up period. Furthermore, the frequency of TLN was similar between patients receiving PBT and those receiving VMAT (PBT vs. VMAT: 4.7% vs. 6.3%, p = 0.76). Kaplan–Meier analysis revealed that the accumulated risks of TLN were similar between PBT and VMAT in patients with any HNC (p = 0.44), NPC (p = 0.84), and non-NPC HNC (p = 0.70). Conclusion Our study demonstrated that patients with NPC are susceptible to TLN during the early period after RT. In addition, PBT may be associated with an equivalent risk of TLN when compared with VMAT in patients with NPC or other HNCs.

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“…Their results show that, not only clinical dose, but also age, V40 GyRBE, hypertension, and dose to at least 1 cc (D1cc) in the temporal lobe, are associated with grade 2 necrosis or greater. This was cross-valuated and used to develop an age*prescription-dose*D1cc (Gy)*hypertension patient-wise model with maximum area under the receiver operating characteristic curve of 0.76 [ 18 ].…”

Section: Clinical Outcomes Datamentioning

confidence: 99%

Impact of Relative Biologic Effectiveness for Proton Therapy for Head and Neck and Skull-Base Tumors: A Technical and Clinical Review

Holtzman,

Mohammadi,

Furutani

et al. 2024

Cancers

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Proton therapy has emerged as a crucial tool in the treatment of head and neck and skull-base cancers, offering advantages over photon therapy in terms of decreasing integral dose and reducing acute and late toxicities, such as dysgeusia, feeding tube dependence, xerostomia, secondary malignancies, and neurocognitive dysfunction. Despite its benefits in dose distribution and biological effectiveness, the application of proton therapy is challenged by uncertainties in its relative biological effectiveness (RBE). Overcoming the challenges related to RBE is key to fully realizing proton therapy’s potential, which extends beyond its physical dosimetric properties when compared with photon-based therapies. In this paper, we discuss the clinical significance of RBE within treatment volumes and adjacent serial organs at risk in the management of head and neck and skull-base tumors. We review proton RBE uncertainties and its modeling and explore clinical outcomes. Additionally, we highlight technological advancements and innovations in plan optimization and treatment delivery, including linear energy transfer/RBE optimizations and the development of spot-scanning proton arc therapy. These advancements show promise in harnessing the full capabilities of proton therapy from an academic standpoint, further technological innovations and clinical outcome studies, however, are needed for their integration into routine clinical practice.

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NTCP Modeling for High-Grade Temporal Radionecroses in a Large Cohort of Patients Receiving Pencil Beam Scanning Proton Therapy for Skull Base and Head and Neck Tumors

Cited by 3 publications

References 32 publications

Research trends of radiation induced temporal lobe injury in patients with nasopharyngeal carcinoma from 2000 to 2022: a bibliometric analysis

Research trends of radiation induced temporal lobe injury in patients with nasopharyngeal carcinoma from 2000 to 2022: a bibliometric analysis

Risk of temporal lobe necrosis between proton beam and volumetric modulated arc therapies in patients with different head and neck cancers

Impact of Relative Biologic Effectiveness for Proton Therapy for Head and Neck and Skull-Base Tumors: A Technical and Clinical Review

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