Title |
Patterns of locoregional failure following post-operative intensity-modulated radiotherapy to oral cavity cancer: quantitative spatial and dosimetric analysis using a deformable image registration workflow
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Published in |
Radiation Oncology, August 2017
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DOI | 10.1186/s13014-017-0868-y |
Pubmed ID | |
Authors |
Abdallah S. R. Mohamed, Andrew J. Wong, Clifton D. Fuller, Mona Kamal, Gary B. Gunn, Jack Phan, William H. Morrison, Beth M. Beadle, Heath Skinner, Stephen Y. Lai, Sean R. Quinlan-Davidson, Abdelaziz M. Belal, Ahmed G. El-Gowily, Steven J. Frank, David I. Rosenthal, Adam S. Garden |
Abstract |
We sought to identify spatial/dosimetric patterns of failure for oral cavity cancer patients receiving post-operative IMRT (PO-IMRT). Two hundred eighty-nine OCC patients receiving PO-IMRT were retrospectively reviewed from 2000 to 2012. Diagnostic CT documenting recurrence (rCT) was co-registered with planning CT (pCT) using a validated deformable image registration software. Manually segmented recurrent gross disease (rGTV) was deformed to co-registered pCTs. Mapped rGTVs were compared dosimetrically to planned dose and spatially to planning target volumes using centroid-based approaches. Failures types were classified using combined spatial/dosimetric criteria: A (central high-dose), B (peripheral high-dose), C (central intermediate/low-dose), D (peripheral intermediate/low-dose), and E (extraneous-dose). Fifty-four patients with recurrence were analyzed; 26 local recurrence, 19 regional recurrence, and 9 both local and regional recurrence. Median time to recurrence was 4 months (range 0-71). Median rGTVs volume was 3.7 cm(3) (IQR 1.4-10.6). For spatial and dosimetric analysis of the patterns of failure, 30 patients (55.5%) were classified as type A (central high-dose). Non-central high dose failures were distributed as follows: 2 (3.7%) type B, 10 (18.5%) type C, 1 (1.8%) type D, and 9 (16.7%) type E. Non-IMRT failure in the matching low-neck field was seen in two patients. No failures were noted at the IMRT-supraclavicular field match-line. Approximately half of patients with local/regional failure had non-central high dose recurrence. Peripheral high dose misses were uncommon reflecting adequate delineation and dose delivery. Future strategies are needed to reduce types C and E failures. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 2 | 29% |
Taiwan | 1 | 14% |
Spain | 1 | 14% |
Nepal | 1 | 14% |
Unknown | 2 | 29% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 4 | 57% |
Scientists | 3 | 43% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 40 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 8 | 20% |
Student > Ph. D. Student | 5 | 13% |
Other | 5 | 13% |
Student > Master | 4 | 10% |
Student > Doctoral Student | 3 | 8% |
Other | 7 | 18% |
Unknown | 8 | 20% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 22 | 55% |
Nursing and Health Professions | 3 | 8% |
Environmental Science | 1 | 3% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 3% |
Biochemistry, Genetics and Molecular Biology | 1 | 3% |
Other | 2 | 5% |
Unknown | 10 | 25% |