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Correlation of tumour and treatment characteristics to dose received by cochlea in volumetric arc therapy

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

This is a radiation field simulation study using CT images designed to see the cochlear dosimetry and its correlation with tumour and treatment characteristics during radiotherapy for head and neck cancers (HNC) for identifying the factors associated with a higher dose delivered to the cochlea.

Methods

From 2018 to 2020, 80 patients with HNC underwent volumetric arc therapy (VMAT) to a dose of 66–70 Gy at 2 Gy per fraction with bilateral cochlea contoured for VMAT optimization as an organ at risk. Minimum, mean and maximum planned radiation dose to the cochlea based on tumour and treatment characteristics and dose-volume histogram variables of VMAT plans were analysed.

Results

Mean (standard deviation, SD) cochlear volume was 0.14 (0.06) cm3 with maximum and mean planned doses of 10.3 (SD = 11.6) Gy and 8.5 (SD = 9.8) Gy, respectively. We found a statistically significant correlation between mean dose received by bilateral cochlea (P—0.000, rright—0.84, rleft—0.78, rmidline—0.92). Tumours of the paranasal sinuses, and the parotids and more advanced T stages were associated with a higher mean dose to cochlea but was not significant statistically. The dose received by the 95% target nodal volume (D95%) showed a significant correlation with the cochlear mean dose (P—0.000, rright—0.85, rleft—0.77, rmidline—0.93)

Conclusion

With VMAT we have achieved a better sparing of cochlea. The mean dose to the cochlea of one side significantly differed from the other side in patients with lateralized cancers. D95% of nodal volume also showed a significant correlation with the cochlear mean dose.

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Availability of data and materials

The datasets used and analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

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Funding

All authors declare that there is no funding involved in this study.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

    Nidhin Das, Kapil Soni, Vidhu Sharma & Amit Goyal

  2. Department of Otorhinolaryngology and Head and Neck Surgery, PGIMER, Chandigarh, India

    Sourabha Kumar Patro

  3. Department of Otorhinolaryngology, All India Institute of Medical Sciences, Himachal Pradesh, Bilaspur, India

    Darwin Kaushal

  4. Department of Radiation Oncology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

    Puneet Pareek & Sri Harsha Kombathula

  5. Department of Physiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

    Abhinav Dixit

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Contributions

All authors were equally involved in conception of the work, data collection, data analysis and interpretation, drafting the article, critical revision of the article, and final approval of the version to be published. Statistical analysis is done by second author.

Corresponding author

Correspondence to Amit Goyal.

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The present study was approved by institutional ethical committee—All India Institute of Medical Sciences Jodhpur, Rajasthan, India (AIIMS/IEC/2018/827).

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Patients were enrolled after obtaining informed consent for participation.

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Das, N., Patro, S.K., Kaushal, D. et al. Correlation of tumour and treatment characteristics to dose received by cochlea in volumetric arc therapy. Eur Arch Otorhinolaryngol 279, 2019–2028 (2022). https://doi.org/10.1007/s00405-021-06950-y

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