TY - JOUR
T1 - Precision association of lymphatic disease spread with radiation-associated toxicity in oropharyngeal squamous carcinomas
AU - Spatial-Non-spatial Multi-Dimensional Analysis of Radiotherapy Treatment/Toxicity Team SMART3
AU - Wentzel, Andrew
AU - Luciani, Timothy
AU - van Dijk, Lisanne V.
AU - Taku, Nicolette
AU - Elgohari, Baher
AU - Mohamed, Abdallah S.R.
AU - Canahuate, Guadalupe
AU - Fuller, Clifton D.
AU - Vock, David M.
AU - Elisabeta Marai, G.
N1 - Publisher Copyright:
© 2021 Elsevier B.V.
PY - 2021/8
Y1 - 2021/8
N2 - Purpose: To determine whether patient similarity in terms of head and neck cancer spread through lymph nodes correlates significantly with radiation-associated toxicity. Materials and methods: 582 head and neck cancer patients received radiotherapy for oropharyngeal cancer (OPC) and had non-metastatic affected lymph nodes in the head and neck. Affected lymph nodes were segmented from pretreatment contrast-enhanced tomography scans and categorized according to consensus guidelines. Similar patients were clustered into 4 groups according to a graph-based representation of disease spread through affected lymph nodes. Correlation between dysphagia-associated symptoms and patient groups was calculated. Results: Out of 582 patients, 26% (152) experienced toxicity during a follow up evaluation 6 months after completion of radiotherapy treatment. Patient groups identified by our approach were significantly correlated with dysphagia, feeding tube, and aspiration toxicity (p <.0005). Discussion: Our results suggest that structural geometry-aware characterization of affected lymph nodes can be used to better predict radiation-associated dysphagia at time of diagnosis, and better inform treatment guidelines. Conclusion: Our work successfully stratified a patient cohort into similar groups using a structural geometry, graph-encoding of affected lymph nodes in oropharyngeal cancer patients, that were predictive of late radiation-associated dysphagia and toxicity.
AB - Purpose: To determine whether patient similarity in terms of head and neck cancer spread through lymph nodes correlates significantly with radiation-associated toxicity. Materials and methods: 582 head and neck cancer patients received radiotherapy for oropharyngeal cancer (OPC) and had non-metastatic affected lymph nodes in the head and neck. Affected lymph nodes were segmented from pretreatment contrast-enhanced tomography scans and categorized according to consensus guidelines. Similar patients were clustered into 4 groups according to a graph-based representation of disease spread through affected lymph nodes. Correlation between dysphagia-associated symptoms and patient groups was calculated. Results: Out of 582 patients, 26% (152) experienced toxicity during a follow up evaluation 6 months after completion of radiotherapy treatment. Patient groups identified by our approach were significantly correlated with dysphagia, feeding tube, and aspiration toxicity (p <.0005). Discussion: Our results suggest that structural geometry-aware characterization of affected lymph nodes can be used to better predict radiation-associated dysphagia at time of diagnosis, and better inform treatment guidelines. Conclusion: Our work successfully stratified a patient cohort into similar groups using a structural geometry, graph-encoding of affected lymph nodes in oropharyngeal cancer patients, that were predictive of late radiation-associated dysphagia and toxicity.
KW - Head and neck cancer
KW - Medical informatics
KW - Oropharynx cancer
KW - Precision medicine
KW - Radiation-associated dysphagia
KW - Statistical data mining
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U2 - 10.1016/j.radonc.2021.06.016
DO - 10.1016/j.radonc.2021.06.016
M3 - Article
C2 - 34126138
AN - SCOPUS:85108585687
SN - 0167-8140
VL - 161
SP - 152
EP - 158
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
ER -