Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States.
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States.
Radiother Oncol. 2021 Apr;157:63-69. doi: 10.1016/j.radonc.2020.11.012. Epub 2020 Nov 18.
To introduce a contouring guideline for the taste bud bearing tongue mucosa for head and neck cancer patients receiving radiotherapy.
CT simulation images of oropharyngeal cancer patients were used to delineate both the whole tongue (extrinsic/intrinsic tongue muscles, floor of mouth) and the taste bud bearing tongue mucosa (method A: adaptation of the whole tongue structure; method B: axial adaptation of a mid-sagittal contour). Volumetric and dosimetric parameters of the whole tongue and the two methods of mucosal delineation, spatial overlap between methods A and B, and inter-observer variability for method B were calculated.
The study cohort was comprised of 70 patients with T1-4 N0-1 tonsillar (83%) and base of tongue (17%) cancers. Most of the comparative parameters between the whole tongue and mucosa (method A) significantly differed (mean, minimum, and maximum dose, V5-V70, D40-D90). The mean dose calculated for the whole tongue deviated on average 3.77 Gy compared to method A. No significant differences were found between methods A and B of the taste bud bearing tongue mucosa structure, and none of the dosimetric parameters differed more than 1.03 Gy on average. The mean Dice similarity coefficient for both mucosal structures was 0.79 ± 0.05, and 0.63 ± 0.12 for the inter-observer analysis of method B.
We defined two methods for delineating the taste bud bearing mucosa and both are equally satisfactory procedures. Either method is preferable over delineation of the whole tongue as organ at risk for taste impairment.
为头颈部癌症接受放疗的患者介绍一种勾画味觉感受器舌黏膜的轮廓指南。
使用口咽癌患者的 CT 模拟图像来勾画整个舌头（外在/内在舌肌、口底）和味觉感受器舌黏膜（方法 A：适应整个舌头结构；方法 B：中矢状面的轴向适应）。计算整个舌头和两种黏膜勾画方法的体积和剂量学参数、方法 A 和 B 之间的空间重叠以及方法 B 的观察者间变异性。
研究队列包括 70 名 T1-4 N0-1 扁桃体（83%）和舌根（17%）癌症患者。整个舌头和黏膜（方法 A）之间的大多数比较参数均有显著差异（平均值、最小值和最大值剂量、V5-V70、D40-D90）。与方法 A 相比，整个舌头的平均剂量平均偏差 3.77 Gy。方法 A 和 B 之间的味觉感受器舌黏膜结构之间没有发现显著差异，并且平均没有超过 1.03 Gy 的剂量学参数差异。两种黏膜结构的平均 Dice 相似系数分别为 0.79±0.05 和 0.63±0.12，方法 B 的观察者间分析。
我们定义了两种勾画味觉感受器黏膜的方法，这两种方法都是同样令人满意的程序。任何一种方法都优于勾画整个舌头作为味觉损伤的危险器官。
