Analysis of skin dose distribution for the prediction of severe radiation dermatitis in head and neck squamous cell carcinoma patients treated with concurrent chemo-radiotherapy
Corresponding Author
Pierluigi Bonomo MD
Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Correspondence
Pierluigi Bonomo, MD., Radiation Oncology, Azienda Ospedaliero – Universitaria Careggi, University of Florence, largo Brambilla 3, 50134 Florence, Italy.
Email: [email protected]
Search for more papers by this authorCinzia Talamonti MS
Medical Physics, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Search for more papers by this authorIsacco Desideri MD
Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Search for more papers by this authorLivia Marrazzo MS
Medical Physics, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Search for more papers by this authorDonato Pezzulla MD
Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Search for more papers by this authorAndrea Rampini MD
Radiation Oncology, Ospedale San Donato, Arezzo, Italy
Search for more papers by this authorSilvia Bertocci MD
Radiation Oncology, Ospedale San Donato, Arezzo, Italy
Search for more papers by this authorRoberta De Majo MD
Radiation Oncology, Ospedale San Donato, Arezzo, Italy
Search for more papers by this authorChiara Gasperi MS
Medical Physics, Ospedale San Donato, Arezzo, Italy
Search for more papers by this authorAssunta Simona Curion MS
Medical Physics, Ospedale San Donato, Arezzo, Italy
Search for more papers by this authorLuciana Lastrucci MD
Radiation Oncology, Ospedale San Donato, Arezzo, Italy
Search for more papers by this authorLuca Dominici MD
Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Search for more papers by this authorStefania Pallotta MS
Medical Physics, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Search for more papers by this authorLorenzo Livi MD
Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Search for more papers by this authorSaverio Caini MD
Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Florence, Italy
Search for more papers by this authorCorresponding Author
Pierluigi Bonomo MD
Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Correspondence
Pierluigi Bonomo, MD., Radiation Oncology, Azienda Ospedaliero – Universitaria Careggi, University of Florence, largo Brambilla 3, 50134 Florence, Italy.
Email: [email protected]
Search for more papers by this authorCinzia Talamonti MS
Medical Physics, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Search for more papers by this authorIsacco Desideri MD
Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Search for more papers by this authorLivia Marrazzo MS
Medical Physics, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Search for more papers by this authorDonato Pezzulla MD
Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Search for more papers by this authorAndrea Rampini MD
Radiation Oncology, Ospedale San Donato, Arezzo, Italy
Search for more papers by this authorSilvia Bertocci MD
Radiation Oncology, Ospedale San Donato, Arezzo, Italy
Search for more papers by this authorRoberta De Majo MD
Radiation Oncology, Ospedale San Donato, Arezzo, Italy
Search for more papers by this authorChiara Gasperi MS
Medical Physics, Ospedale San Donato, Arezzo, Italy
Search for more papers by this authorAssunta Simona Curion MS
Medical Physics, Ospedale San Donato, Arezzo, Italy
Search for more papers by this authorLuciana Lastrucci MD
Radiation Oncology, Ospedale San Donato, Arezzo, Italy
Search for more papers by this authorLuca Dominici MD
Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Search for more papers by this authorStefania Pallotta MS
Medical Physics, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Search for more papers by this authorLorenzo Livi MD
Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Search for more papers by this authorSaverio Caini MD
Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Florence, Italy
Search for more papers by this authorAbstract
Background
We investigated whether the pattern of intensity-modulated radiotherapy (IMRT) dose distribution to the skin can be correlated with the development of G3/G4 radiation dermatitis (RD).
Methods
A frequency-matched cohort analysis was perfomed on patients treated with IMRT and concurrent cisplatin or cetuximab. Risk ratios were obtained by fitting Poisson regression models.
Results
The incidence of G3/G4 RD was 41.1% in 90 patients included (50% vs 36.6% in the cetuximab and cisplatin cohorts, respectively). In multivariate analysis, PS ≥ 1 and weight loss at RT completion >10 kg were the only factors that retained significance. The best dosimetric predictive accuracy was provided by 19.9 cc and 5.8 cc of skin ring 2 mm V50 and V60, respectively (AUC: 0.61 for both).
Conclusion
Along with clinical factors, the pattern of dose distribution to a ring structure localized 2 mm below the patient's surface may help predict the development of severe RD.
CONFLICT OF INTEREST
The authors declare no potential conflict of interest.
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