Basu Sattwik, Chatterjee Subrata, Chatterjee Kaustav, Samanta Sattama, Saha Solanki, Hossain Sk Toslim, Mondal Pritha, Biswas Shyamal
Department of Radiation Oncology, Medical College and Hospital, Kolkata, India.
Rep Pract Oncol Radiother. 2024 Dec 4;29(5):579-587. doi: 10.5603/rpor.102824. eCollection 2024.
Radiation dermatitis (RD) or skin toxicity is one of the most common acute side effects of radiation in head and neck cancer patients. This study aims to correlate the pattern of volumetric-modulated arc therapy (VMAT) dose distribution to the skin with the grades of RD.
80 plans of histopathologically proven squamous cell carcinoma head and neck patients already treated with definitive concurrent chemoradiation [66-70 Gy in 33-35# or 66 Gy in 30# in simultaneous integrated boost (SIB), with concurrent Cisplatin 100 mg/m 3 weekly] at our institution between November 2022 and November 2023 were retrieved from our digital archives. For each plan, 1 ring structure was created 3mm below the external skin surface, and the parameters V, V, V and D were collected from the same. These parameters were correlated with grades of RD as per Common Terminology Criteria for Adverse Events (CTCAE) v5.0. The statistical analysis was done using MedCalc software version 22.021.
The incidence of G2/G3 RD was 52.5%, and its incidence was significantly correlated with all of the four parameters. Statistically significant (p < 0.001) dosimetric predictive accuracy was provided by 71.66 cc, 29.98 cc and 7.624 cc of the 3mm skin ring V V and V, respectively.
The dose distribution pattern to a skin layer stationed 3mm below the surface may help predict the development of severe RD in head and neck cancer patients receiving concurrent chemoradiation.
放射性皮炎（RD）或皮肤毒性是头颈癌患者放疗最常见的急性副作用之一。本研究旨在将容积调强弧形放疗（VMAT）的皮肤剂量分布模式与放射性皮炎的分级相关联。
从我们的数字档案中检索了2022年11月至2023年11月期间在本机构接受确定性同步放化疗[33 - 35次分割给予66 - 70 Gy或同步推量（SIB）30次分割给予66 Gy，同时每周给予顺铂100 mg/m³]的80例经组织病理学证实的头颈鳞状细胞癌患者的计划。对于每个计划，在皮肤外表面下方3mm处创建1个环形结构，并从该结构收集参数V、V、V和D。这些参数根据不良事件通用术语标准（CTCAE）v5.0与放射性皮炎的分级相关联。使用MedCalc软件版本22.021进行统计分析。
2/3级放射性皮炎的发生率为52.5%，其发生率与所有四个参数均显著相关。3mm皮肤环形结构的V、V和V分别为71.66 cc、29.98 cc和7.624 cc时，提供了具有统计学意义（p < 0.001）的剂量学预测准确性。
对于接受同步放化疗的头颈癌患者，位于表面下方3mm处的皮肤层的剂量分布模式可能有助于预测严重放射性皮炎的发生。
