Brain radiotherapy and dorsal vagal complex irradiation: A new organ at risk to decrease radiation-induced nausea and vomiting?
Purpose: Nausea is a common symptom in patients irradiated for benign brain tumors. The dorsal vagal complex (DVC) located in the brainstem (BS) has been identified as the center of nausea and vomiting. The objective of our study was to determine an association between mean dose to the DVC and nause...
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Elsevier
2025-03-01
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| Series: | Clinical and Translational Radiation Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630824001794 |
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| author | Valentine Caspar Nicolas Giraud Thomas Charleux Arnaud Beddok Brieuc Bernard Maelle Martin Juliette Thariat Aymeri Huchet Véronique Vendrely Charles Dupin |
| author_facet | Valentine Caspar Nicolas Giraud Thomas Charleux Arnaud Beddok Brieuc Bernard Maelle Martin Juliette Thariat Aymeri Huchet Véronique Vendrely Charles Dupin |
| author_sort | Valentine Caspar |
| collection | DOAJ |
| description | Purpose: Nausea is a common symptom in patients irradiated for benign brain tumors. The dorsal vagal complex (DVC) located in the brainstem (BS) has been identified as the center of nausea and vomiting. The objective of our study was to determine an association between mean dose to the DVC and nausea. Material: Details of consecutive patients treated for benign brain tumors at the Bordeaux University Hospital using normofractionated intensity modulated radiotherapy technique, without chemotherapy, were accessed. DVC delineation was performed on MRI T1 sequences with gadolinium injection using a reference atlas. Results: Among 102 patients, 68 were women, and median age was 61.5 years. The tumors treated were primarily meningiomas (80 %) and neurinomas (17 %). The median dose was 54 Gy [48.6–57.6 Gy]. In the overall population, 40 (39.2 %) had nausea, requiring anti-nausea treatment for 23 (57.5 %). Patients with nausea were significantly younger (45.5 versus 63.2 years, p = 0.014).For patients without and with nausea, the mean DVC dose was 8.9 Gy versus 21.6 Gy (p < 10-4), respectively, and the mean brainstem dose was 16.9 Gy versus 27.1 Gy (p < 10-3). The optimal threshold for mean DVC dose was 8.82 Gy (AUC = 0.731, p < 10-4). Patients with DVC receiving less than 8.82 Gy had a 16 % risk to have nausea versus 62 % for patients receiving more than 8.82 Gy (p < 10-4). The optimal threshold for mean brainstem dose was 24 Gy (AUC = 0.715p < 0.0001). Conclusion: The mean DVC dose is significantly associated with radiation-induced nausea. A dose constraint below 8.82 Gy to decrease the incidence of radiation-induced nausea needs to be validated by a prospective study. |
| format | Article |
| id | doaj-art-6d68d7791062437eb3df5aa9ed0d2623 |
| institution | Kabale University |
| issn | 2405-6308 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj-art-6d68d7791062437eb3df5aa9ed0d26232025-01-30T05:14:26ZengElsevierClinical and Translational Radiation Oncology2405-63082025-03-0151100902Brain radiotherapy and dorsal vagal complex irradiation: A new organ at risk to decrease radiation-induced nausea and vomiting?Valentine Caspar0Nicolas Giraud1Thomas Charleux2Arnaud Beddok3Brieuc Bernard4Maelle Martin5Juliette Thariat6Aymeri Huchet7Véronique Vendrely8Charles Dupin9Department of Radiation Oncology, Bordeaux University Hospital, F33000 Bordeaux, FranceDepartment of Radiation Oncology, Bordeaux University Hospital, F33000 Bordeaux, FranceDepartment of Radiation Oncology, Centre d’Imagerie Médicale de Radiothérapie et d’Oncologie de Dordogne, Périgueux, FranceDepartment of Radiation Oncology, Institut Godinot, Reims, France; Université de Reims Champagne-Ardenne, CRESTIC, Reims, FranceDepartment of Radiation Oncology, Bordeaux University Hospital, F33000 Bordeaux, FranceDepartment of Radiation Oncology, Bordeaux University Hospital, F33000 Bordeaux, FranceDepartment of Radiation Oncology, Centre Francois Baclesse, 14000 Caen, FranceDepartment of Radiation Oncology, Bordeaux University Hospital, F33000 Bordeaux, FranceDepartment of Radiation Oncology, Bordeaux University Hospital, F33000 Bordeaux, France; BRIC (BoRdeaux Institute of onCology), UMR1312, INSERM, University of Bordeaux, F-33000 Bordeaux, FranceDepartment of Radiation Oncology, Bordeaux University Hospital, F33000 Bordeaux, France; BRIC (BoRdeaux Institute of onCology), UMR1312, INSERM, University of Bordeaux, F-33000 Bordeaux, France; Corresponding author.Purpose: Nausea is a common symptom in patients irradiated for benign brain tumors. The dorsal vagal complex (DVC) located in the brainstem (BS) has been identified as the center of nausea and vomiting. The objective of our study was to determine an association between mean dose to the DVC and nausea. Material: Details of consecutive patients treated for benign brain tumors at the Bordeaux University Hospital using normofractionated intensity modulated radiotherapy technique, without chemotherapy, were accessed. DVC delineation was performed on MRI T1 sequences with gadolinium injection using a reference atlas. Results: Among 102 patients, 68 were women, and median age was 61.5 years. The tumors treated were primarily meningiomas (80 %) and neurinomas (17 %). The median dose was 54 Gy [48.6–57.6 Gy]. In the overall population, 40 (39.2 %) had nausea, requiring anti-nausea treatment for 23 (57.5 %). Patients with nausea were significantly younger (45.5 versus 63.2 years, p = 0.014).For patients without and with nausea, the mean DVC dose was 8.9 Gy versus 21.6 Gy (p < 10-4), respectively, and the mean brainstem dose was 16.9 Gy versus 27.1 Gy (p < 10-3). The optimal threshold for mean DVC dose was 8.82 Gy (AUC = 0.731, p < 10-4). Patients with DVC receiving less than 8.82 Gy had a 16 % risk to have nausea versus 62 % for patients receiving more than 8.82 Gy (p < 10-4). The optimal threshold for mean brainstem dose was 24 Gy (AUC = 0.715p < 0.0001). Conclusion: The mean DVC dose is significantly associated with radiation-induced nausea. A dose constraint below 8.82 Gy to decrease the incidence of radiation-induced nausea needs to be validated by a prospective study.http://www.sciencedirect.com/science/article/pii/S2405630824001794Radiation induced nauseaDorsal vagal complexBrain tumors |
| spellingShingle | Valentine Caspar Nicolas Giraud Thomas Charleux Arnaud Beddok Brieuc Bernard Maelle Martin Juliette Thariat Aymeri Huchet Véronique Vendrely Charles Dupin Brain radiotherapy and dorsal vagal complex irradiation: A new organ at risk to decrease radiation-induced nausea and vomiting? Clinical and Translational Radiation Oncology Radiation induced nausea Dorsal vagal complex Brain tumors |
| title | Brain radiotherapy and dorsal vagal complex irradiation: A new organ at risk to decrease radiation-induced nausea and vomiting? |
| title_full | Brain radiotherapy and dorsal vagal complex irradiation: A new organ at risk to decrease radiation-induced nausea and vomiting? |
| title_fullStr | Brain radiotherapy and dorsal vagal complex irradiation: A new organ at risk to decrease radiation-induced nausea and vomiting? |
| title_full_unstemmed | Brain radiotherapy and dorsal vagal complex irradiation: A new organ at risk to decrease radiation-induced nausea and vomiting? |
| title_short | Brain radiotherapy and dorsal vagal complex irradiation: A new organ at risk to decrease radiation-induced nausea and vomiting? |
| title_sort | brain radiotherapy and dorsal vagal complex irradiation a new organ at risk to decrease radiation induced nausea and vomiting |
| topic | Radiation induced nausea Dorsal vagal complex Brain tumors |
| url | http://www.sciencedirect.com/science/article/pii/S2405630824001794 |
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