Intensity-modulated proton therapy and osteoradionecrosis in oropharyngeal cancer

Wencheng Zhang; Xiaodong Zhang; Pei Yang; Pierre Blanchard; Adam S. Garden; Brandon Gunn; C. David Fuller; Mark Chambers; Katherine A. Hutcheson; Rong Ye; Stephen Y. Lai; Mohamed Abdallah Sherif Radwan; X. Ron Zhu; Steven J. Frank

doi:10.1016/j.radonc.2017.05.006

Intensity-modulated proton therapy and osteoradionecrosis in oropharyngeal cancer

Wencheng Zhang, Xiaodong Zhang, Pei Yang, Pierre Blanchard, Adam S. Garden, Brandon Gunn, C. David Fuller, Mark Chambers, Katherine A. Hutcheson, Rong Ye, Stephen Y. Lai, Mohamed Abdallah Sherif Radwan, X. Ron Zhu, Steven J. Frank

Research output: Contribution to journal › Article › peer-review

81 Citations (Scopus)

Abstract

Purpose We compared mandibular doses and osteoradionecrosis in patients with oropharyngeal cancer after intensity-modulated radiation therapy (IMRT) or intensity-modulated proton therapy (IMPT). Methods and materials We identified 584 patients who received definitive radiotherapy for oropharyngeal cancer from January 2011 through June 2014 at MD Anderson Cancer Center (534 IMRT and 50 IMPT). The dosimetric variables and osteoradionecrosis were compared with Chi-square test or Fisher's exact test. Results Median follow-up time for all patients (534 IMRT and IMPT) was 33.8 months (33.8 months IMRT vs. 34.6 months IMPT, P = 0.854), and median time to osteoradionecrosis was 11.4 months (range 6.74–16.1 months). Mandibular doses were lower for patients treated with IMPT (minimum 0.8 vs. 7.3 Gy; mean 25.6 vs. 41.2 Gy; P < 0.001), and osteoradionecrosis rates were lower as well: 2% IMPT (1 grade 1), 7.7% IMRT (12 grade 4, 5 grade 3, 1 grade 2 and 23 grade 1). Osteoradionecrosis location depended on the primary tumor site and high-dose field in the mandible. Conclusions Osteoradionecrosis events were significantly associated with higher dose irradiation to mandibular. Use of IMPT minimized excess irradiation of the mandible and consequently reduced the risk of osteoradionecrosis for oropharyngeal cancer.

Original language	English
Pages (from-to)	401-405
Number of pages	5
Journal	Radiotherapy and Oncology
Volume	123
Issue number	3
DOIs	https://doi.org/10.1016/j.radonc.2017.05.006
Publication status	Published - 1 Jun 2017
Externally published	Yes

Keywords

IMPT
IMRT
Mandibular dose
Oropharyngeal cancer
Osteoradionecrosis
Particle therapy

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10.1016/j.radonc.2017.05.006

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@article{13fd37079e824179920fa6d243bdbd48,

title = "Intensity-modulated proton therapy and osteoradionecrosis in oropharyngeal cancer",

abstract = "Purpose We compared mandibular doses and osteoradionecrosis in patients with oropharyngeal cancer after intensity-modulated radiation therapy (IMRT) or intensity-modulated proton therapy (IMPT). Methods and materials We identified 584 patients who received definitive radiotherapy for oropharyngeal cancer from January 2011 through June 2014 at MD Anderson Cancer Center (534 IMRT and 50 IMPT). The dosimetric variables and osteoradionecrosis were compared with Chi-square test or Fisher's exact test. Results Median follow-up time for all patients (534 IMRT and IMPT) was 33.8 months (33.8 months IMRT vs. 34.6 months IMPT, P = 0.854), and median time to osteoradionecrosis was 11.4 months (range 6.74–16.1 months). Mandibular doses were lower for patients treated with IMPT (minimum 0.8 vs. 7.3 Gy; mean 25.6 vs. 41.2 Gy; P < 0.001), and osteoradionecrosis rates were lower as well: 2% IMPT (1 grade 1), 7.7% IMRT (12 grade 4, 5 grade 3, 1 grade 2 and 23 grade 1). Osteoradionecrosis location depended on the primary tumor site and high-dose field in the mandible. Conclusions Osteoradionecrosis events were significantly associated with higher dose irradiation to mandibular. Use of IMPT minimized excess irradiation of the mandible and consequently reduced the risk of osteoradionecrosis for oropharyngeal cancer.",

keywords = "IMPT, IMRT, Mandibular dose, Oropharyngeal cancer, Osteoradionecrosis, Particle therapy",

author = "Wencheng Zhang and Xiaodong Zhang and Pei Yang and Pierre Blanchard and Garden, {Adam S.} and Brandon Gunn and Fuller, {C. David} and Mark Chambers and Hutcheson, {Katherine A.} and Rong Ye and Lai, {Stephen Y.} and Radwan, {Mohamed Abdallah Sherif} and Zhu, {X. Ron} and Frank, {Steven J.}",

note = "Publisher Copyright: {\textcopyright} 2017 Elsevier B.V.",

year = "2017",

month = jun,

day = "1",

doi = "10.1016/j.radonc.2017.05.006",

language = "English",

volume = "123",

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journal = "Radiotherapy and Oncology",

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TY - JOUR

T1 - Intensity-modulated proton therapy and osteoradionecrosis in oropharyngeal cancer

AU - Zhang, Wencheng

AU - Zhang, Xiaodong

AU - Yang, Pei

AU - Blanchard, Pierre

AU - Garden, Adam S.

AU - Gunn, Brandon

AU - Fuller, C. David

AU - Chambers, Mark

AU - Hutcheson, Katherine A.

AU - Ye, Rong

AU - Lai, Stephen Y.

AU - Radwan, Mohamed Abdallah Sherif

AU - Zhu, X. Ron

AU - Frank, Steven J.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Purpose We compared mandibular doses and osteoradionecrosis in patients with oropharyngeal cancer after intensity-modulated radiation therapy (IMRT) or intensity-modulated proton therapy (IMPT). Methods and materials We identified 584 patients who received definitive radiotherapy for oropharyngeal cancer from January 2011 through June 2014 at MD Anderson Cancer Center (534 IMRT and 50 IMPT). The dosimetric variables and osteoradionecrosis were compared with Chi-square test or Fisher's exact test. Results Median follow-up time for all patients (534 IMRT and IMPT) was 33.8 months (33.8 months IMRT vs. 34.6 months IMPT, P = 0.854), and median time to osteoradionecrosis was 11.4 months (range 6.74–16.1 months). Mandibular doses were lower for patients treated with IMPT (minimum 0.8 vs. 7.3 Gy; mean 25.6 vs. 41.2 Gy; P < 0.001), and osteoradionecrosis rates were lower as well: 2% IMPT (1 grade 1), 7.7% IMRT (12 grade 4, 5 grade 3, 1 grade 2 and 23 grade 1). Osteoradionecrosis location depended on the primary tumor site and high-dose field in the mandible. Conclusions Osteoradionecrosis events were significantly associated with higher dose irradiation to mandibular. Use of IMPT minimized excess irradiation of the mandible and consequently reduced the risk of osteoradionecrosis for oropharyngeal cancer.

AB - Purpose We compared mandibular doses and osteoradionecrosis in patients with oropharyngeal cancer after intensity-modulated radiation therapy (IMRT) or intensity-modulated proton therapy (IMPT). Methods and materials We identified 584 patients who received definitive radiotherapy for oropharyngeal cancer from January 2011 through June 2014 at MD Anderson Cancer Center (534 IMRT and 50 IMPT). The dosimetric variables and osteoradionecrosis were compared with Chi-square test or Fisher's exact test. Results Median follow-up time for all patients (534 IMRT and IMPT) was 33.8 months (33.8 months IMRT vs. 34.6 months IMPT, P = 0.854), and median time to osteoradionecrosis was 11.4 months (range 6.74–16.1 months). Mandibular doses were lower for patients treated with IMPT (minimum 0.8 vs. 7.3 Gy; mean 25.6 vs. 41.2 Gy; P < 0.001), and osteoradionecrosis rates were lower as well: 2% IMPT (1 grade 1), 7.7% IMRT (12 grade 4, 5 grade 3, 1 grade 2 and 23 grade 1). Osteoradionecrosis location depended on the primary tumor site and high-dose field in the mandible. Conclusions Osteoradionecrosis events were significantly associated with higher dose irradiation to mandibular. Use of IMPT minimized excess irradiation of the mandible and consequently reduced the risk of osteoradionecrosis for oropharyngeal cancer.

KW - IMPT

KW - IMRT

KW - Mandibular dose

KW - Oropharyngeal cancer

KW - Osteoradionecrosis

KW - Particle therapy

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U2 - 10.1016/j.radonc.2017.05.006

DO - 10.1016/j.radonc.2017.05.006

M3 - Article

C2 - 28549794

AN - SCOPUS:85019617581

SN - 0167-8140

VL - 123

SP - 401

EP - 405

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

IS - 3

ER -

Intensity-modulated proton therapy and osteoradionecrosis in oropharyngeal cancer

Abstract

Keywords

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