TY  - JOUR
T1  - BAŞ-BOYUN KANSERİ YOĞUNLUK AYARLI RADYOTERAPİSİNDE PAROTİS BEZİ HACMİ VE HEDEF HACİM İLİŞKİLERİNİN PAROTİS BEZİ DOZUNA ETKİSİ
TT  - THE EFFECT OF PAROTID GLAND VOLUME AND TARGET VOLUME RELATIONSHIPS ON PAROTID GLAND DOSE IN INTENSITY MODULATED RADIOTHERAPY OF HEAD AND NECK CANCER
AU  - Özseven, Alper
AU  - Kaymak, Zümrüt Arda
AU  - Özkan, Emine Elif
AU  - Çobanbaş, İbrahim
PY  - 2021
DA  - December
Y2  - 2021
DO  - 10.17343/sdutfd.981789
JF  - Medical Journal of Süleyman Demirel University
JO  - Med J SDU
PB  - Süleyman Demirel University
WT  - DergiPark
SN  - 1300-7416
SP  - 655
EP  - 661
VL  - 28
IS  - 4
LA  - tr
AB  - AmaçBaş-boyun kanseri radyoterapisinde, parotis ve hedefhacim ilişkilerinin, parotisin alacağı radyasyon dozuüzerine etkisini araştırmaktır.Gereç ve YöntemBaş-boyun bölgesi kanserleri tanısı ile küratif, definitifveya postoperatif adjuvan radyoterapi uygulanmışhastalardan rastgele 50 hasta seçildi. Konturlamasonrası her hastanın sağ ve sol parotislerinin ayrı ayrıkraniyo-kaudal uzunluğu (KKU), parotis hacmi (Vparotis),parotis ile kesişen planlanan hedef hacim (PTV)dozu, sağ ve sol parotisin ayrı ayrı PTV70 hedefi ileörtüşen KKU, parotis seviyesinde olan fakat parotis ilekesişmeyen maksimum PTV dozu ve parotisin PTVile kesişen hacminin toplam parotis hacmine oranıkaydedildi. Ayrıca, parotis seviyesindeki kesitlerdePTV70 hacminin olup-olmadığı; var ise yerleşiminintek taraflı mı veya bilateral olup-olmadığı kaydedildi.Yoğunluk ayarlı radyoterapi planlaması sonrası,doz-hacim histogramları kullanılarak ortalama parotisdozu (Dmean), 20 Gy ve üstü doz alan parotis hacmioranı (V20) ve 30 Gy ve üstü doz alan parotis hacmioranı (V30) değerleri ölçüldü. Ortalama parotis dozunun26 Gy üstünde olmasına etki edebilecek faktörlerlojistik regresyon analizi ile incelendi. Sınır değerbelirleme amacıyla Receiver operating characteristics(ROC) eğrisi analizi kullanıldı.BulgularTüm parotislerin ortanca Dmean, V20 ve V30 değerlerisırasıyla, 26,55 Gy (14,74-66,78), %50,91 (26,53-100) ve %32,21 (7,12-100) idi. Dmean>26Gy olangrupta, parotis hacmi istatistiksel olarak anlamlı yüksekbulundu (p=0,027). Dmean>26Gy olan grupta,parotisin PTV ile kesişen hacminin tüm parotise oranıbelirgin yüksekti (%1,25 karşın %7,06, p
KW  - Baş-boyun kanseri
KW  - parotis bezi
KW  - yoğunluk ayarlı radyoterapi
N2  - ObjectiveTo investigate the effect of parotid and target volumerelationships on the radiation dose to be received bythe parotid in head and neck cancer radiotherapy.Material and MethodsFifty patients were randomly selected from the patientswho underwent curative, definitive or postoperativeadjuvant radiotherapy with the diagnosis of headand neck cancer. After contouring, the cranio-caudallength (CCL) of the right and left parotids, the parotidvolume (Vparotis), the planning target volume (PTV)dose overlapping with the parotids, the CCL of theright and left parotid overlapping with the PTV 70target, the maximum PTV dose at parotid level but notoverlapping with parotids and the ratio of the parotidvolume overlapping with PTV to the total parotidvolume were recorded. In addition, it was recordedwhether there was a PTV70 volume in the slices atparotid level and whether it was located unilaterallyor bilaterally. After the intensity modulated radiationtherapy planning, by using dose-volume histograms,mean parotid gland dose (Dmean), volume ratio ofparotid gland that received 20 Gy and more doses(V20), and volume ratio of parotid gland that received30 Gy and more doses (V30) were measured. Thefactors that may affect the mean parotid dose above26 Gy were analyzed by logistic regression analysis.Receiver operating characteristics (ROC) curveanalysis was used to determine the cut-off value.ResultsThe median Dmean, V20 and V30 value of all parotidglands was 26.55 Gy (14.74-66.78), 50.91% (26.53-100) and 32.21% (7.12-100), respectively. The parotidgland volume was found to be statistically significanthigher in the group with Dmean>26Gy (p=0.027). Inthe group with Dmean>26Gy, the ratio of the volumeof the parotid gland overlapping with the PTV to theentire parotid gland was significantly higher (1.25% vs.7.06%, p
CR  - [1] Jemal A, Siegel R, Xu J, Ward, E. Cancer statistics 2010. CA: a cancer journal for clinicians 2010; 60: 277–23. https://doi.org/10.3322/caac.20073
CR  - [2] Fitzmaurice C, Allen C, Barber RM, Barregard L, Bhutta ZA, Brenner H, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015. JAMA Oncol. 2017;3:524–48. https://doi.org/10.1001/jamaoncol.2016.5688
CR  - [3] Beech N, Robinson S, Porceddu S, Batstone M. Dental management of patients irradiated for head and neck cancer. Aust Dent J. 2014;59:20-8. https://doi.org/10.1111/adj.12134
CR  - [4] Deasy JO, Moiseenko V, Marks L, Chao KS, Nam J, Eisbruch A. Radiotherapy dose-volume effects on salivary gland function. Int J Radiat Oncol Biol Phys. 2010;76 (3 Suppl):S58-S63. doi:10.1016/j.ijrobp.2009.06.090
CR  - [5] De Sanctis V, Bossi P, Sanguineti G, Trippa F, Ferrari D, Bacigalupo A, et al. Mucositis in head and neck cancer patients treated with radiotherapy and systemic therapies: literature review and consensus statements. Crit Rev Oncol Hematol. 2016; 100: 147-66. https://doi.org/10.1016/j.critrevonc.2016.01.010
CR  - [6] Yeh SA. Radiotherapy for head and neck cancer. Semin Plast Surg. 2010; 24:127-36. https://doi.org/10.1055/s-0030-1255330
CR  - [7] Ozseven A & Kara Ü. Verification of Percentage Depth-Doses with Monte Carlo Simulation and Calculation of Mass Attenuation Coefficients for Various Patient Tissues in Radiation Therapy . Süleyman Demirel University Journal of Health Sciences 2020; 11: 224-6 . Retrieved from https://dergipark.org.tr/tr/pub/sdusbed/issue/54917/705468
CR  - [8] Palta JR & Mackie TR. Intensity-modulated radiation therapy—the state of the art. Madison (WI): Medical Physics Publishing; 2003.
CR  - [9] Keçeci A , Özdemir F . Ağız kuruluğunun etiyolojisi ve tedavisinde günümüzdeki yaklaşım. SDÜ Tıp Fakültesi Dergisi. 2005; 12(4): 58-67.
CR  - [10] Millunchick CH, Zhen H, Redler G, Liao Y, Turian JV. A model for predicting the dose to the parotid glands based on their relative overlapping with planning target volumes during helical radiotherapy. J Appl Clin Med Phys. 2018;19(2):48-53. doi:10.1002/acm2.12203
CR  - [11] Ugurlu M, Ozkan EE, Ozseven A. The effect of ionizing radiation on properties of fluoride-releasing restorative materials. Braz Oral Res. 2020; 34:e005. https://doi.org/10.1590/1807-3107bor-2020.vol34.0005
CR  - [12] Stephens LC, Schultheiss TE, Price RE, Ang KK, Peters LJ. Radiation apoptosis of serous acinar cells of salivary and lacrimal glands. Cancer. 1991; 67:1539–4
CR  - [13] Harrison LB, Zelefsky MJ, Pfister D, Carper E, Raben A, Kraus DH, et al. Detailed quality of life assessment in patients treated with primary radiotherapy for squamous cell cancer of the base of the tongue. Head Neck. 1997;19:169–175.
CR  - [14] Eisbruch A, Rhodus N, Rosenthal D, Murphy B, Rasch C, Sonis S, et al. How should we measure and report radiotherapy-induced xerostomia? Semin Radiat Oncol. 2003;13:226–234.
CR  - [15] Chao KS, Deasy JO, Markman J, Haynie J, Perez CA, Purdy JA, et al. A prospective study of salivary function sparing in patients with head-and-neck cancers receiving intensity-modulated or three-dimensional radiation therapy. Int J Radiat Oncol Biol Phys. 2001;49:907–916.
CR  - [16] Stock M, Dörr W, Stromberger C, Mock U, Koizar S, Pötter R, et al. Investigations on parotid gland recovery after IMRT in head and neck tumor patients. Strahlenther Onkol. 2010;186(12):665-671. doi:10.1007/s00066-010-2157-7
CR  - [17] Roesink JM, Moerland MA, Battermann JJ, Hordijk GJ, Terhaard Chris HJ. Quantitative dose-volume response analysis of changes in parotid gland function after radiotherapy in the head-and-neck region. Int J Radiat Oncol Biol Phys. 2001;51:938–946.
CR  - [18] Eisbruch A, Ten H, Randall K, Kim HM, Marsh LH, Ship JA. Dose, volumes, and function relationships in parotid salivary glands following conformal and intensity-modulated irradiation of head and neck cancer. Int J Radiat Oncol Biol Phys. 1999;45:577–587.
CR  - [19] Nutting CM, Morden JP, Harrington KJ, Urbano TG, Bhide SA, Clark C, et al. Parotid‑sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): A phase 3 multicentre randomised controlled trial. Lancet Oncol 2011;12:127‑36.
CR  - [20] Bjordal K, Kaasa S, Mastekaasa A. Quality of life in patients treated for head and neck cancer: A follow‑up study 7 to 11 years after radiotherapy. Int J Radiat Oncol Biol Phys 1994;28:847‑56.
CR  - [21] Gensheimer MF, Hummel-Kramer SM, Cain D, Quang TS. Simple tool for prediction of parotid gland sparing in intensity-modulated radiation therapy. Med Dosim. 2015;40:232–234.
CR  - [22] Hunt MA, Jackson A, Narayana A, Lee N. Geometric factors influencing dosimetric sparing of the parotid glands using IMRT. Int J Radiat Oncol Biol Phys. 2006;66:296–304.
CR  - [23] Blanco AI, Chao KS, El Naqa I, Franklin GE, Zakarian K, Vicic M, et al. Dose-volume modeling of salivary function in patients with head-and-neck cancer receiving radiotherapy. Int J Radiat Oncol Biol Phys. 2005; 62:1055–1069
CR  - [24] Saarilahti K, Kouri M, Collan J, Kangasmäki A, Atula T, Joensuu H, et al. Sparing of the submandibular glands by intensity modulated radiotherapy in the treatment of head and neck cancer. Radiother Oncol. 2006 Mar;78(3):270-5. doi: 10.1016/j.radonc.2006.02.017. Epub 2006 Mar 27. Erratum in: Radiother Oncol. 2006 Jul;80(1):107-8. PMID: 16564589.
UR  - https://doi.org/10.17343/sdutfd.981789
L1  - https://dergipark.org.tr/en/download/article-file/1920665
ER  -