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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
Author(s) -
Bonomo Pierluigi,
Talamonti Cinzia,
Desideri Isacco,
Marrazzo Livia,
Pezzulla Donato,
Rampini Andrea,
Bertocci Silvia,
De Majo Roberta,
Gasperi Chiara,
Curion Assunta Simona,
Lastrucci Luciana,
Dominici Luca,
Pallotta Stefania,
Livi Lorenzo,
Caini Saverio
Publication year - 2020
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25997
Subject(s) - cetuximab , medicine , radiation therapy , head and neck cancer , oncology , nuclear medicine , head and neck squamous cell carcinoma , cohort , incidence (geometry) , poisson regression , erysipelas , multivariate analysis , basal cell , surgery , cancer , population , colorectal cancer , physics , environmental health , optics
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.