Muthukumar Arun, Khanpara Sekhar, Wegner Robert C, Goel Atin, Hernandez Mike, Cata Juan P
Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030 USA.
Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, TX USA.
Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4334-4339. doi: 10.1007/s12070-024-04855-w. Epub 2024 Jun 28.
Radiation treatment can modify soft tissue dynamics depending on the extent and location of irradiation. We hypothesized that head and neck radiotherapy caused alterations in cricothyroid membrane (CTM) related dimensions.
Primary objective was to evaluate changes in the cricothyroid membrane height (CTMH) and skin-to-CTM distance (STCD) in patients who underwent radiation treatment for head and neck cancers.
Pre- and post-head-and-neck cancer-radiated computed tomography (CT) scans were analyzed retrospectively. The patients' demographics (age, sex, body mass index, cancer location), radiation dose and laterality, time from radiation initiation to CT scan assessments were summarized. CTMH and STCD were measured from pre-and post-radiation CT scans. Pre- and post-radiation comparisons were conducted using a paired -test, or Wilcoxon signed-rank test if more appropriate. Chi-squared or Fisher's Exact test were used for categorical variables.
Among 231 study patients, who underwent head and neck radiotherapy in our institution 73.2% were males, and the median age of total population was 66 years (31-93). The median BMI was 25.2 kg/m (13.8-47.2). The median time from first radiation dose to CT scan assessment was 29.5 months (2-115).The median pre- and post-radiation CTMH were 8.7 mm (3-16.2) and 7.5 mm (3.1-14.3) respectively. The median pre- and post-radiation STCD were 11.7 mm (2.9-71.1) and 10.2 mm (3.9-38) respectively.
In summary our patient population had significant reduction of cricothyroid membrane related dimensions following head-and-neck radiotherapy, which can limit the localization of the cricothyroid membrane.
Retrospective cohort study.
放射治疗可根据照射范围和部位改变软组织动力学。我们推测头颈部放疗会导致环甲膜(CTM)相关维度发生改变。
主要目的是评估头颈部癌症放疗患者的环甲膜高度(CTMH)和皮肤至环甲膜距离(STCD)的变化。
对头颈部癌症放疗前后的计算机断层扫描(CT)进行回顾性分析。总结患者的人口统计学特征(年龄、性别、体重指数、癌症部位)、放射剂量和照射侧别、从开始放疗到CT扫描评估的时间。从放疗前后的CT扫描中测量CTMH和STCD。放疗前后的比较采用配对t检验,若更合适则采用Wilcoxon符号秩检验。分类变量采用卡方检验或Fisher精确检验。
在我们机构接受头颈部放疗的231例研究患者中,73.2%为男性,总体中位年龄为66岁(31 - 93岁)。中位体重指数为25.2kg/m²(13.8 - 47.2)。从首次放疗剂量到CT扫描评估的中位时间为29.5个月(2 - 115个月)。放疗前后CTMH的中位数分别为8.7mm(3 - 16.2mm)和7.5mm(3.1 - 14.3mm)。放疗前后STCD的中位数分别为11.7mm(2.9 - 71.1mm)和10.2mm(3.9 - 38mm)。
总之,我们的患者群体在头颈部放疗后环甲膜相关维度显著减小,这可能会限制环甲膜的定位。
证据水平III:回顾性队列研究。