Dose/Volume histogram patterns in Salivary Gland subvolumes influence xerostomia injury and recovery

Xerostomia is a common consequence of radiotherapy in head and neck cancer. The objective was to compare the regional radiation dose distribution in patients that developed xerostomia within 6 months of radiotherapy and those recovered from xerostomia within 18 months post-radiotherapy. We developed...

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Bibliographic Details
Published in:Scientific reports 2019-03, Vol.9 (1), p.3616, Article 3616
Main Authors: Han, Peijin, Lakshminarayanan, Pranav, Jiang, Wei, Shpitser, Ilya, Hui, Xuan, Lee, Sang Ho, Cheng, Zhi, Guo, Yue, Taylor, Russell H., Siddiqui, Sauleh A., Bowers, Michael, Sheikh, Khadija, Kiess, Ana, Page, Brandi R., Lee, Junghoon, Quon, Harry, McNutt, Todd R.
Format: Article
Language:English
Subjects:
692/308/409
692/4028/67/1536
Cancer
Head & neck cancer
Humanities and Social Sciences
multidisciplinary
Oral cavity
Radiation therapy
Regression analysis
Salivary gland
Science
Science (multidisciplinary)
Xerostomia
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Summary:Xerostomia is a common consequence of radiotherapy in head and neck cancer. The objective was to compare the regional radiation dose distribution in patients that developed xerostomia within 6 months of radiotherapy and those recovered from xerostomia within 18 months post-radiotherapy. We developed a feature generation pipeline to extract dose volume histogram features from geometrically defined ipsilateral/contralateral parotid glands, submandibular glands, and oral cavity surrogates for each patient. Permutation tests with multiple comparisons were performed to assess the dose difference between injury vs. non-injury and recovery vs. non-recovery. Ridge logistic regression models were applied to predict injury and recovery using clinical features along with dose features (D10-D90) of the subvolumes extracted from oral cavity and salivary gland contours + 3 mm peripheral shell. Model performances were assessed by the area under the receiver operating characteristic curve (AUC) using nested cross-validation. We found that different regional dose/volume metrics patterns exist for injury vs. recovery. Compared to injury, recovery has increased importance to the subvolumes receiving lower dose. Within the subvolumes, injury tends to have increased importance towards D10 from D90. This suggests that different threshold for xerostomia injury and recovery. Injury is induced by the subvolumes receiving higher dose, and the ability to recover can be preserved by further reducing the dose to subvolumes receiving lower dose.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-019-40228-y