We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Normal tissue complication probability modeling for cochlea constraints to avoid causing tinnitus after head-and-neck intensity-modulated radiation therapy.
- Authors
Tsair-Fwu Lee; Shyh-An Yeh; Pei-Ju Chao; Liyun Chang; Chien-Liang Chiu; Hui-Min Ting; Hung-Yu Wang; Yu-Jie Huang; Lee, Tsair-Fwu; Yeh, Shyh-An; Chao, Pei-Ju; Chang, Liyun; Chiu, Chien-Liang; Ting, Hui-Min; Wang, Hung-Yu; Huang, Yu-Jie
- Abstract
<bold>Background: </bold>Radiation-induced tinnitus is a side effect of radiotherapy in the inner ear for cancers of the head and neck. Effective dose constraints for protecting the cochlea are under-reported. The aim of this study is to determine the cochlea dose limitation to avoid causing tinnitus after head-and-neck cancer (HNC) intensity-modulated radiation therapy (IMRT).<bold>Methods: </bold>In total 211 patients with HNC were included; the side effects of radiotherapy were investigated for 422 inner ears in the cohort. Forty-nine of the four hundred and twenty-two samples (11.6%) developed grade 2+ tinnitus symptoms after IMRT, as diagnosed by a clinician. The Late Effects of Normal Tissues-Subjective, Objective, Management, Analytic (LENT-SOMA) criteria were used for tinnitus evaluation. The logistic and Lyman-Kutcher-Burman (LKB) normal tissue complication probability (NTCP) models were used for the analyses.<bold>Results: </bold>The NTCP-fitted parameters were TD 50 = 46.31 Gy (95% CI, 41.46-52.50), γ 50 = 1.27 (95% CI, 1.02-1.55), and TD 50 = 46.52 Gy (95% CI, 41.91-53.43), m = 0.35 (95% CI, 0.30-0.42) for the logistic and LKB models, respectively. The suggested guideline TD 20 for the tolerance dose to produce a 20% complication rate within a specific period of time was TD 20 = 33.62 Gy (95% CI, 30.15-38.27) (logistic) and TD 20 = 32.82 Gy (95% CI, 29.58-37.69) (LKB).<bold>Conclusions: </bold>To maintain the incidence of grade 2+ tinnitus toxicity <20% in IMRT, we suggest that the mean dose to the cochlea should be <32 Gy. However, models should not be extrapolated to other patient populations without further verification and should first be confirmed before clinical implementation.
- Subjects
COCHLEA; HEAD tumors; DOSE-response relationship (Radiation); MATHEMATICAL models; COMPUTERS in medicine; NECK tumors; RADIATION doses; RADIATION injuries; RADIOTHERAPY; TINNITUS; THEORY
- Publication
Radiation Oncology, 2015, Vol 10, Issue 1, p1
- ISSN
1748-717X
- Publication type
journal article
- DOI
10.1186/s13014-015-0501-x