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• W1997360975 abstract "Radiotherapy for head and neck malignancies continues to be an area of research and quality improvement. Dysgeusia is a significant acute and long term toxicity experienced by patients receiving head and neck radiotherapy. Unlike other acute effects of esophagitis, mucositis, and xerostomia, dysgeusia has no significant medical intervention available. At this time, the only believed therapy is to minimize dose to the tongue, however this is often difficult due to close tumor volumes, and or the later effects of sparing other structures such as the salivary glands. This study aims to investigate the possibility of reducing dose to the oral tongue to reduce clinical dysgeusia without compromising PTV coverage and other normal structure preservation. Ten patients were retrospectively selected from our institutional database that were previously planned and treated with IMRT for head and neck cancer. Five patients had a unilateral T1-T2 tonsillar cancer with N1-2B neck lymph nodes (LN), and 5 patients had supraglottic cancers of similar stage. Exclusion criteria included bilateral gross disease in the LN or primary, extension of the primary to the oral tongue or a positive level I LN. The oral tongue was defined as the anterior 2/3rds of the tongue. Any primary lesion that extended to the base of the tongue had 5mm cropped out of the oral tongue structure from the high dose PTV margin without violating the border of the oral tongue. The plans were then re-optimized to evaluate the ability to reduce the dose of the contoured oral tongue to a target mean dose of 2000cGy. All plans were normalized to the 95% isodose line without exception. Regarding the pre-study dosimetry, the mean dose to the target PTV was 7462 cGy, and the mean dose to the oral tongue was 4033 ±830 cGy. Following study re-optimization, the mean dose to the target PTV was consistent at 7471 cGy and the mean dose to the tongue was reduced to 2210 ±239 cGy for all plans (P = <0.001). This represents an average decrease in mean oral tongue dose of 1823cGy per plan or (45%). As a consequence of this re-optimization, the mean increase to the ipsalateral parotid was not significant (19 cGy, P = 0.98). The mean PTV maximum dose increased by 29cGy and the mean PTV minimum dose decreased by 131cGy both were also insignificant. This study suggests that select head and neck cancers with unilateral gross disease can achieve significant tongue sparing. This was done without a significant compromise of target PTV coverage or increase in normal structure dosing in an attempt to improve acute and long term dysgeusia. The optimal dose reduction to improve clinical dysgeusia remains unknown, and warrants further investigation." @default.
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• W1997360975 date "2014-09-01" @default.
• W1997360975 modified "2023-09-26" @default.
• W1997360975 title "A Dosimetric Evaluation of Oral Tongue Sparing to Reduce Dysgeusia in Head and Neck Cancers" @default.
• W1997360975 doi "https://doi.org/10.1016/j.ijrobp.2014.05.1557" @default.
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