Swallowing sparing intensity modulated radiotherapy (SW-IMRT) in head and neck cancer: Clinical validation according to the model-based approach

Miranda E M C Christianen; Arjen Van Der Schaaf; Hans Paul Van Der Laan; Irma M. Verdonck-De Leeuw; Patricia Doornaert; Olga Chouvalova; Roel J H M Steenbakkers; Charles René Leemans; Sjoukje F. Oosting; Bernard F A M Van Der Laan; Jan L N Roodenburg; Ben J. Slotman; Hendrik P. Bijl; Johannes A. Langendijk

doi:10.1016/j.radonc.2015.11.009

Swallowing sparing intensity modulated radiotherapy (SW-IMRT) in head and neck cancer: Clinical validation according to the model-based approach

Miranda E M C Christianen, Arjen Van Der Schaaf, Hans Paul Van Der Laan, Irma M. Verdonck-De Leeuw, Patricia Doornaert, Olga Chouvalova, Roel J H M Steenbakkers, Charles René Leemans, Sjoukje F. Oosting, Bernard F A M Van Der Laan, Jan L N Roodenburg, Ben J. Slotman, Hendrik P. Bijl, Johannes A. Langendijk^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

8 Citations (Scopus)

Abstract

Purpose The aim of this study was to clinically validate a multivariable normal tissue complication probability (NTCP) model for grade 2-4 swallowing dysfunction at 6 months after radiotherapy or chemoradiation (SWAL_M6) in head and neck cancer patients treated with swallowing sparing intensity modulated radiotherapy (SW-IMRT) and to test if SW-IMRT resulted in a reduction of the prevalence of SWAL_M6. Materials and methods The primary endpoint was SWAL_M6. For all 186 patients, a standard IMRT (parotid sparing) and a SW-IMRT plan (additional constraints for swallowing organs at risk) was created. The difference in NTCP for SWAL_M6 (ΔNTCP_SWALM6 = NTCP_standard - NTCP_SW-IMRT) was calculated. Patients were treated with SW-IMRT. The external validation of the NTCP model was analyzed by comparing performance measures. Results The mean ΔNTCP_SWALM6 was 4.9% (range 0.01-17.3%), with a significant lower mean predicted NTCP_SW-IMRT of 22.6% (95% CI 20.2-24.9%), compared to NTCP_standard of 27.5% (95% CI 24.9-29.9%) (p <0.001). There was a perfect correspondence of NTCP_SW-IMRT with the observed prevalence of SWAL_M6 (22.6%). The overall model performance, discrimination and 'goodness of fit' were good. Conclusion We externally validated the multivariable NTCP model for SWAL_M6 in SW-IMRT treated patients, showing reduced swallowing dysfunction by reducing the dose parameters included in this NTCP model.

Original language	English
Pages (from-to)	298-303
Number of pages	6
Journal	Radiotherapy & Oncology
Volume	118
Issue number	2
DOIs	https://doi.org/10.1016/j.radonc.2015.11.009
Publication status	Published - 1 Feb 2016
Externally published	Yes

Keywords

Head and neck cancer
Model based approach
Radiotherapy
Swallowing sparing IMRT

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10.1016/j.radonc.2015.11.009

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Christianen, M. E. M. C., Van Der Schaaf, A., Van Der Laan, H. P., Verdonck-De Leeuw, I. M., Doornaert, P., Chouvalova, O., Steenbakkers, R. J. H. M., Leemans, C. R., Oosting, S. F., Van Der Laan, B. F. A. M., Roodenburg, J. L. N., Slotman, B. J., Bijl, H. P., & Langendijk, J. A. (2016). Swallowing sparing intensity modulated radiotherapy (SW-IMRT) in head and neck cancer: Clinical validation according to the model-based approach. Radiotherapy & Oncology, 118(2), 298-303. https://doi.org/10.1016/j.radonc.2015.11.009

@article{8e6b20d27ad74ffa9ea3d036c22eb349,

title = "Swallowing sparing intensity modulated radiotherapy (SW-IMRT) in head and neck cancer: Clinical validation according to the model-based approach",

abstract = "Purpose The aim of this study was to clinically validate a multivariable normal tissue complication probability (NTCP) model for grade 2-4 swallowing dysfunction at 6 months after radiotherapy or chemoradiation (SWALM6) in head and neck cancer patients treated with swallowing sparing intensity modulated radiotherapy (SW-IMRT) and to test if SW-IMRT resulted in a reduction of the prevalence of SWALM6. Materials and methods The primary endpoint was SWALM6. For all 186 patients, a standard IMRT (parotid sparing) and a SW-IMRT plan (additional constraints for swallowing organs at risk) was created. The difference in NTCP for SWALM6 (ΔNTCPSWALM6 = NTCPstandard - NTCPSW-IMRT) was calculated. Patients were treated with SW-IMRT. The external validation of the NTCP model was analyzed by comparing performance measures. Results The mean ΔNTCPSWALM6 was 4.9\% (range 0.01-17.3\%), with a significant lower mean predicted NTCPSW-IMRT of 22.6\% (95\% CI 20.2-24.9\%), compared to NTCPstandard of 27.5\% (95\% CI 24.9-29.9\%) (p <0.001). There was a perfect correspondence of NTCPSW-IMRT with the observed prevalence of SWALM6 (22.6\%). The overall model performance, discrimination and 'goodness of fit' were good. Conclusion We externally validated the multivariable NTCP model for SWALM6 in SW-IMRT treated patients, showing reduced swallowing dysfunction by reducing the dose parameters included in this NTCP model.",

keywords = "Head and neck cancer, Model based approach, Radiotherapy, Swallowing sparing IMRT",

author = "Christianen, \{Miranda E M C\} and \{Van Der Schaaf\}, Arjen and \{Van Der Laan\}, \{Hans Paul\} and \{Verdonck-De Leeuw\}, \{Irma M.\} and Patricia Doornaert and Olga Chouvalova and Steenbakkers, \{Roel J H M\} and Leemans, \{Charles Ren{\'e}\} and Oosting, \{Sjoukje F.\} and \{Van Der Laan\}, \{Bernard F A M\} and Roodenburg, \{Jan L N\} and Slotman, \{Ben J.\} and Bijl, \{Hendrik P.\} and Langendijk, \{Johannes A.\}",

year = "2016",

month = feb,

day = "1",

doi = "10.1016/j.radonc.2015.11.009",

language = "English",

volume = "118",

pages = "298--303",

journal = "Radiotherapy \& Oncology",

issn = "0167-8140",

publisher = "Elsevier Ireland Ltd",

number = "2",

}

Christianen, MEMC, Van Der Schaaf, A, Van Der Laan, HP, Verdonck-De Leeuw, IM, Doornaert, P, Chouvalova, O, Steenbakkers, RJHM, Leemans, CR, Oosting, SF, Van Der Laan, BFAM, Roodenburg, JLN, Slotman, BJ, Bijl, HP & Langendijk, JA 2016, 'Swallowing sparing intensity modulated radiotherapy (SW-IMRT) in head and neck cancer: Clinical validation according to the model-based approach', Radiotherapy & Oncology, vol. 118, no. 2, pp. 298-303. https://doi.org/10.1016/j.radonc.2015.11.009

Swallowing sparing intensity modulated radiotherapy (SW-IMRT) in head and neck cancer: Clinical validation according to the model-based approach. / Christianen, Miranda E M C; Van Der Schaaf, Arjen; Van Der Laan, Hans Paul et al.
In: Radiotherapy & Oncology, Vol. 118, No. 2, 01.02.2016, p. 298-303.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Swallowing sparing intensity modulated radiotherapy (SW-IMRT) in head and neck cancer

T2 - Clinical validation according to the model-based approach

AU - Christianen, Miranda E M C

AU - Van Der Schaaf, Arjen

AU - Van Der Laan, Hans Paul

AU - Verdonck-De Leeuw, Irma M.

AU - Doornaert, Patricia

AU - Chouvalova, Olga

AU - Steenbakkers, Roel J H M

AU - Leemans, Charles René

AU - Oosting, Sjoukje F.

AU - Van Der Laan, Bernard F A M

AU - Roodenburg, Jan L N

AU - Slotman, Ben J.

AU - Bijl, Hendrik P.

AU - Langendijk, Johannes A.

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Purpose The aim of this study was to clinically validate a multivariable normal tissue complication probability (NTCP) model for grade 2-4 swallowing dysfunction at 6 months after radiotherapy or chemoradiation (SWALM6) in head and neck cancer patients treated with swallowing sparing intensity modulated radiotherapy (SW-IMRT) and to test if SW-IMRT resulted in a reduction of the prevalence of SWALM6. Materials and methods The primary endpoint was SWALM6. For all 186 patients, a standard IMRT (parotid sparing) and a SW-IMRT plan (additional constraints for swallowing organs at risk) was created. The difference in NTCP for SWALM6 (ΔNTCPSWALM6 = NTCPstandard - NTCPSW-IMRT) was calculated. Patients were treated with SW-IMRT. The external validation of the NTCP model was analyzed by comparing performance measures. Results The mean ΔNTCPSWALM6 was 4.9% (range 0.01-17.3%), with a significant lower mean predicted NTCPSW-IMRT of 22.6% (95% CI 20.2-24.9%), compared to NTCPstandard of 27.5% (95% CI 24.9-29.9%) (p <0.001). There was a perfect correspondence of NTCPSW-IMRT with the observed prevalence of SWALM6 (22.6%). The overall model performance, discrimination and 'goodness of fit' were good. Conclusion We externally validated the multivariable NTCP model for SWALM6 in SW-IMRT treated patients, showing reduced swallowing dysfunction by reducing the dose parameters included in this NTCP model.

AB - Purpose The aim of this study was to clinically validate a multivariable normal tissue complication probability (NTCP) model for grade 2-4 swallowing dysfunction at 6 months after radiotherapy or chemoradiation (SWALM6) in head and neck cancer patients treated with swallowing sparing intensity modulated radiotherapy (SW-IMRT) and to test if SW-IMRT resulted in a reduction of the prevalence of SWALM6. Materials and methods The primary endpoint was SWALM6. For all 186 patients, a standard IMRT (parotid sparing) and a SW-IMRT plan (additional constraints for swallowing organs at risk) was created. The difference in NTCP for SWALM6 (ΔNTCPSWALM6 = NTCPstandard - NTCPSW-IMRT) was calculated. Patients were treated with SW-IMRT. The external validation of the NTCP model was analyzed by comparing performance measures. Results The mean ΔNTCPSWALM6 was 4.9% (range 0.01-17.3%), with a significant lower mean predicted NTCPSW-IMRT of 22.6% (95% CI 20.2-24.9%), compared to NTCPstandard of 27.5% (95% CI 24.9-29.9%) (p <0.001). There was a perfect correspondence of NTCPSW-IMRT with the observed prevalence of SWALM6 (22.6%). The overall model performance, discrimination and 'goodness of fit' were good. Conclusion We externally validated the multivariable NTCP model for SWALM6 in SW-IMRT treated patients, showing reduced swallowing dysfunction by reducing the dose parameters included in this NTCP model.

KW - Head and neck cancer

KW - Model based approach

KW - Radiotherapy

KW - Swallowing sparing IMRT

UR - https://www.scopus.com/pages/publications/84960223307

U2 - 10.1016/j.radonc.2015.11.009

DO - 10.1016/j.radonc.2015.11.009

M3 - Article

C2 - 26700602

AN - SCOPUS:84960223307

SN - 0167-8140

VL - 118

SP - 298

EP - 303

JO - Radiotherapy & Oncology

JF - Radiotherapy & Oncology

IS - 2

ER -

Swallowing sparing intensity modulated radiotherapy (SW-IMRT) in head and neck cancer: Clinical validation according to the model-based approach

Abstract

Keywords

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