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The influence of field size and other radiotherapy parameters on acute toxicity in pharyngolaryngeal cancers

Der Einflu\ der Feldgrö\e und anderer Bestrahlungsparameter auf die akute ToxizitÄt bei Rachen- und Kehlkopfkarzinomen

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Abstract

Background

Accelerated radiotherapy and/or chemo-radiotherapy of the head and neck region decrease the tolerance of acute responding tissues. Tissue tolerance is also field size dependent.

Patients and Method

An attempt to retrospectively quantify the risk of acute toxicity (peak scores) with field size was undertaken in 286 patients irradiated for unresected head and neck tumors with or without chemotherapy, and with or without accelerated radiotherapy between 1979 and 1990. A Grade-3 to -4 acute toxicity score (RTOG) and > 5% weight loss were chosen as endpoints.

Results

For Grade-3 to -4 toxicity, the risk increased from 0.06 for 5 x 5 cm2 to 0.68 for 17 x 17 cm2 fields and conventional radiotherapy, and from 0.33 for 5 x 5 cm2 to 0.94 for 17 x 17 cm2 and multiple daily fractionation. For > 5% weight loss, the risk ranged from 0.07 for 5 x 5 cm2 to 0.94 for 17 x 17 cm2 fields.

Conclusions

The size of the cervical fields receiving the first 50 Gy was an indicator for severe acute toxicity and weight loss. Taking these data into account may help to improve preventive and treatment measures.

Zusammenfassung

Hintergrund

Im Hals-Nasen-Ohren-Bereich vermindern sowohl die akzelerierte Fraktionierung als auch die zusÄtzliche Chemotherapie die akute Toleranz der Strahlentherapie, welche ebenfalls von der Feldgrö\e beeinflu\t wird.

Patienten und Methode

Das Ziel dieser Arbeit war es, in AbhÄngigkeit vom Fraktionierungsschema und dem Einsatz einer Chemotherapie bei 286 bestrahlten, nichtoperierten Patienten mit Larynxoder Pharynxkarzinomen den Einflu\ der Feldgrö\e auf die akute MorbiditÄt quantitativ zu untersuchen. Als Endpunkte wurden die akute ToxizitÄt RTOG-Grad 3 bis 4 und > 5% Gewichtsverlust festgehalten.

Resultate

Bezüglich akuter ToxizitÄt Grad 3 bis 4 nahm das Risiko bei einer monofraktionierten Bestrahlung von 0,06 für 5 x 5 cm2 bis auf 0,68 für 17 x 17 cm2 Feldgrö\en und von 0,33 für 5 x 5 cm2 bis auf 0,94 für 17 × 17 cm2 Feldgrö\en im Falle von mehreren Bestrahlungssitzungen pro Tag zu. In bezug auf > 5% Gewichtsabnahme variierte das Risiko zwischen 0,07 für 5 x 5 cm2 und 0,94 für 17 x 17 cm2 Feldgrö\en.

Schlu\folgerungen

Die Grö\e der Felder, über welche die ersten 50 Gy eingestrahlt wurden, korrelierte signifikant sowohl mit schwerer akuter ToxizitÄt als auch mit Gewichtsabnahme (Tabelle 1). Diese Daten könnten künftig bei der Auswahl von Hochrisikopatienten von Nutzen sein, um die frühzeitige Anwendung prÄventiver Ma\nahmen zur Verminderung der akuten MorbiditÄt bei der Bestrahlung im HNO-Bereich zu bedenken.

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Authors and Affiliations

  1. Radiation Oncology Department, University Hospital of Geneva, Switzerland

    Raymond Miralbell, Abdelkarim S. Allal & Bert Pastoors

  2. Medical Informatics Department, University Hospital of Geneva, Switzerland

    Bernadette Mermillod

Authors
  1. Raymond Miralbell
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  2. Abdelkarim S. Allal
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  3. Bernadette Mermillod
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  4. Bert Pastoors
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Correspondence to Raymond Miralbell.

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Miralbell, R., Allal, A.S., Mermillod, B. et al. The influence of field size and other radiotherapy parameters on acute toxicity in pharyngolaryngeal cancers. Strahlenther Onkol 175, 74–77 (1999). https://doi.org/10.1007/BF02753846

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  • DOI: https://doi.org/10.1007/BF02753846

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