Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2013

Open Access 01-12-2013 | Research article

Radiation-induced temporal lobe injury after intensity modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume-outcome analysis

Authors: Ying Sun, Guan-Qun Zhou, Zhen-Yu Qi, Li Zhang, Shao-Min Huang, Li-Zhi Liu, Li Li, Ai-Hua Lin, Jun Ma

Published in: BMC Cancer | Issue 1/2013

Login to get access

Abstract

Background

To identify the radiation volume effect and significant dosimetric parameters for temporal lobe injury (TLI) and determine the radiation dose tolerance of the temporal lobe (TL) in nasopharyngeal carcinoma (NPC) patients treated with intensity modulated radiation therapy (IMRT).

Methods

Twenty NPC patients with magnetic resonance imaging (MRI)-diagnosed unilateral TLI were reviewed. Dose-volume data was retrospectively analyzed.

Results

Paired samples t-tests showed all dosimetric parameters significantly correlated with TLI, except the TL volume (TLV) and V75 (the TLV that received ≥75 Gy, P = 0.73 and 0.22, respectively). Receiver operating characteristic (ROC) curves showed V10 and V20 (P = 0.552 and 0.11, respectively) were the only non-significant predictors from V10 to V70 for TLI. D0.5cc (dose to 0.5 ml of the TLV) was an independent predictor for TLI (P < 0.001) in multivariate analysis; the area under the ROC curve for D0.5cc was 0.843 (P < 0.001), and the cutoff point 69 Gy was deemed as the radiation dose limit. The distribution of high dose ‘hot spot’ regions and the location of TLI were consistent.

Conclusions

A D0.5cc of 69 Gy may be the dose tolerance of the TL. The risk of TLI was highly dependent on high dose ‘hot spots’ in the TL; physicians should be cautious of such ‘hot spots’ in the TL during IMRT treatment plan optimization, review and approval.
Appendix
Available only for authorised users
Literature
1.
Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D: Global cancer statistics. CA Cancer J Clin. 2011, 61: 69-90. 10.3322/caac.20107.CrossRefPubMed
2.
Lee AW, Law SC, Ng SH, Chan DK, Poon YF, Foo W, Tung SY, Cheung FK, Ho JH: Retrospective analysis of nasopharyngeal carcinoma treated during 1976–1985: late complications following megavoltage irradiation. Br J Radiol. 1992, 65 (778): 918-928. 10.1259/0007-1285-65-778-918.CrossRefPubMed
3.
Xia P, Fu KK, Wong GW, Akazawa C, Verhey LJ: Comparison of treatment plans involving intensity-modulated radiotherapy for nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2000, 48 (2): 329-337a. 10.1016/S0360-3016(00)00585-X.CrossRefPubMed
4.
Emami B, Lyman J, Brown A, Coia L, Goitein M, Munzenrider JE, Shank B, Solin LJ, Wesson M: Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys. 1991, 21 (1): 109-122. 10.1016/0360-3016(91)90171-Y.CrossRefPubMed
5.
Pharynx (Including Base of Tongue, Soft Palate, and Uvula). AJCC Cancer Staging manual. Edited by: Edge SB, Fritz AG, Byrd DR, Greene FL, Compton CC, Trotti A. 2010, New York: Springer, 41-56. 7
6.
Li WF, Sun Y, Chen M, Tang LL, Liu LZ, Mao YP, Chen L, Zhou GQ, Li L, Ma J: Locoregional extension patterns of nasopharyngeal carcinoma and suggestions for clinical target volume delineation. Chin J Cancer. 2012, 31 (12): 579-587. 10.5732/cjc.012.10095.CrossRefPubMedPubMedCentral
7.
ICRU report. Vol. 50: Prescribing, recording, and reporting photon beam therapy. 1993, Maryland: International Commission on Radiation Units and Measurements
8.
ICRU Report. Vol. 62: Prescribing, recording, and reporting photon beam therapy (supplement to ICRU report 50). 1999, Maryland: International Commission on Radiation Units and Measurements
9.
Wang YX, King AD, Zhou H, Leung SF, Abrigo J, Chan YL, Hu CW, Yeung DK, Ahuja AT: Evolution of radiation-induced brain injury: MR imaging-based study. Radiology. 2010, 254 (1): 210-218. 10.1148/radiol.09090428.CrossRefPubMed
10.
Withers HR, Taylor JM, Maciejewski B: Treatment volume and tissue tolerance. Int J Radiat Oncol Biol Phys. 1988, 14 (4): 751-759. 10.1016/0360-3016(88)90098-3.CrossRefPubMed
11.
Lo SS, Lu JJ, Kong L: Long-Term Complication in the Treatment of Nasopharyngeal Carcinoma. Nasopharyngeal Cancer Multidisciplinary Management. Edited by: Lu JJ, Cooper JS, Lee AW. 2010, New York: Springer, 287-288.
12.
Milner B: Memory and the medial temporal regions of the brain. Biology of Memory. Edited by: Pribram KH, Broadbent DE. 1970, New York: Academic, 29-50.
13.
Lee AW, Kwong DL, Leung SF, Tung SY, Sze WM, Sham JS, Teo PM, Leung TW, Wu PM, Chappell R, Peters LJ, Fowler JF: Factors affecting risk of symptomatic temporal lobe necrosis: significance of fractional dose and treatment time. Int J Radiat Oncol Biol Phys. 2002, 53 (1): 75-85. 10.1016/S0360-3016(02)02711-6.CrossRefPubMed
14.
Jen YM, Hsu WL, Chen CY, Hwang JM, Chang LP, Lin YS, Su WF, Chen CM, Liu DW, Chao HL: Different risks of symptomatic brain necrosis in NPC patients treated with different altered fractionated radiotherapy techniques. Int J Radiat Oncol Biol Phys. 2001, 51 (2): 344-348. 10.1016/S0360-3016(01)01631-5.CrossRefPubMed
15.
Sause WT, Scott C, Krisch R, Rotman M, Sneed PK, Janjan N, Davis L, Curran W, Choi KN, Selim H: Phase I/II trial of accelerated fractionation in brain metastases RTOG 85–28. Int J Radiat Oncol Biol Phys. 1993, 26 (4): 653-657. 10.1016/0360-3016(93)90284-3.CrossRefPubMed
16.
Lawrence YR, Li XA, Naqa I, Hahn CA, Marks LB, Merchant TE, Dicker AP: Radiation dose-volume effects in the brain. Int J Radiat Oncol Biol Phys. 2010, 76 (3): S20-27. 10.1016/j.ijrobp.2009.02.091.CrossRefPubMedPubMedCentral
17.
Su SF, Huang Y, Xiao WW, Huang SM, Han F, Xie CM, Lu TX: Clinical and dosimetric characteristics of temporal lobe injury following intensity modulated radiotherapy of nasopharyngeal carcinoma. Radiother Oncol. 2012, 104 (3): 312-316. 10.1016/j.radonc.2012.06.012.CrossRefPubMed
18.
Schlampp I, Karger CP, Jäkel O, Scholz M, Didinger B, Nikoghosyan A, Hoess A, Krämer M, Edler L, Debus J, Schulz-Ertner D: Temporal lobe reactions after radiotherapy with carbon ions: incidence and estimation of the relative biological effectiveness by the local effect model. Int J Radiat Oncol Biol Phys. 2011, 80 (3): 815-823. 10.1016/j.ijrobp.2010.03.001.CrossRefPubMed
19.
Lee AW, Ng WT, Hung WM, Choi CW, Tung R, Ling YH, Cheng PT, Yau TK, Chang AT, Leung SK, Lee MC, Bentzen SM: Major late toxicities after conformal radiotherapy for nasopharyngeal carcinoma patient and treatment-related risk factors. Int J Radiat Oncol Biol Phys. 2009, 73 (4): 1121-1128. 10.1016/j.ijrobp.2008.05.023.CrossRefPubMed
20.
Kam MK, Teo PM, Chau RM, Cheung KY, Choi PH, Kwan WH, Leung SF, Zee B, Chan AT: Treatment of nasopharyngeal carcinoma with intensity-modulated radiotherapy: the Hong Kong experience. Int J Radiat Oncol Biol Phys. 2004, 60 (5): 1440-1450. 10.1016/j.ijrobp.2004.05.022.CrossRefPubMed
Metadata
Title
Radiation-induced temporal lobe injury after intensity modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume-outcome analysis
Authors
Ying Sun
Guan-Qun Zhou
Zhen-Yu Qi
Li Zhang
Shao-Min Huang
Li-Zhi Liu
Li Li
Ai-Hua Lin
Jun Ma
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2013
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-13-397

Other articles of this Issue 1/2013

BMC Cancer 1/2013 Go to the issue

Research article

N-benzyladriamycin-14-valerate (AD 198) exhibits potent anti-tumor activity on TRAF3-deficient mouse B lymphoma and human multiple myeloma

Research article

Targeting both IGF-1R and mTOR synergistically inhibits growth of renal cell carcinoma in vitro

Research article

A comparison of trends in melanoma mortality in New Zealand and Australia: the two countries with the highest melanoma incidence and mortality in the world

Research article

The long non-coding RNA HOTAIR indicates a poor prognosis and promotes metastasis in non-small cell lung cancer

Research article

Treatment with a combination of the ErbB (HER) family blocker afatinib and the IGF-IR inhibitor, NVP-AEW541 induces synergistic growth inhibition of human pancreatic cancer cells

Editorial

Recognizing the role of surgical oncology and cancer imaging in the multidisciplinary approach to cancer: an important area of future scholarly growth for BMC Cancer
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits