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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Radiation Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1394111
This article is part of the Research Topic Radiotherapy for Head and Neck Cancers View all 8 articles

Normal tissue complication probability model of temporal lobe injury following reirradiation of IMRT for local recurrent nasopharyngeal carcinoma

Provisionally accepted
Xiyin Guan Xiyin Guan 1*Jiyou Peng Jiyou Peng 2Jiayao Sun Jiayao Sun 1Xing Xing Xing Xing 2Chaosu Hu Chaosu Hu 2*
  • 1 Shanghai Proton and Heavy Ion Center (SPHIC), Shanghai, China
  • 2 Shanghai Cancer Center, Fudan University, Shanghai, Shanghai Municipality, China

The final, formatted version of the article will be published soon.

    We tried to establish the normal tissue complication probability (NTCP) model of temporal lobe injury of recurrent nasopharyngeal carcinoma (NPC) patients after two courses of intensity modulated radiotherapy (IMRT) to provide more reliable dose-volume data reference to set the temporal lobe tolerance dose for recurrent NPC patients in the future.Methods and materials: Recurrent NPC patients were randomly divided into training data set and validation data set in a ratio of 2:1, All the temporal lobes (TLs) were re-contoured as R/L structures and named separately in the MIM system. The dose distribution of the initial IMRT plan was deformed into the second course planning CT via MIM software to get the deformed dose. Equivalent dose of TLs in 2Gy fractions was calculated via linear quadratic model, using an α/β=3 for temporal lobes. NTCP model that correlated the irradiated volume of the temporal lobe and? the clinical variables were evaluated in a multivariate prediction model using AUC analysis.Results: From Jan. 2010 to Dec. 2020, 78 patients were enrolled into our study. Among which 26 (33.3%) developed TLI. The most important factors affecting TLI was the sum-dose d1.5cc of TL, while the possible clinical factors did not reach statistically significant differences in multivariate analysis. According to NTCP model, the TD5 and TD50 EQD2 dose of sum-dose d1.5cc were , respectively. For the accumulated EQD2 dose, the area under ROC shadow was 0.8702 (0.7577-0.9828) in model validation, p＜0.001.In this study, a NTCP model of temporal lobe injury after a second course of IMRT for recurrent nasopharyngeal carcinoma was established. TD5 and TD50 doses of temporal lobe injury after re-RT were obtained according to the model, and the model was verified by validation set data.

    Keywords: Recurrent nasopharyngeal carcinoma, Intensity modulated radiotherapy, Reirradiation, Temporal lobe injury, Normal tissue complication probability model. Abbreviations: NPC, nasopharyngeal carcinoma, IMRT, intensity modulated radiotherapy, TLI, Temporal lobe injury, NTCP, Normal tissue complication probability, GTV, gross tumor volume, CTV, clinical tumor volume, CT, computed tomography, PET-CT, Positron emission tomographycomputed tomography

    Received: 01 Mar 2024; Accepted: 10 May 2024.

    Copyright: © 2024 Guan, Peng, Sun, Xing and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Xiyin Guan, Shanghai Proton and Heavy Ion Center (SPHIC), Shanghai, China
    Chaosu Hu, Shanghai Cancer Center, Fudan University, Shanghai, 200032, Shanghai Municipality, China

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