Detection of alteration in carotid artery volumetry using standard-of-care computed tomography surveillance scans following unilateral radiation therapy for early-stage tonsillar squamous cell carcinoma survivors: a cross-sectional internally-matched carotid isodose analysis
Aim: This study leveraged standard-of-care CT scans of patients receiving unilateral radiotherapy (RT) for early tonsillar cancer to detect volumetric changes in the carotid arteries, and determine whether there is a dose–response relationship. Methods: Disease-free cancer survivors (>3 months si...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-03-01
|
| Series: | Clinical and Translational Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630825000023 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832582189524451328 |
|---|---|
| author | Efstratios Koutroumpakis Mohamed A. Naser Abdallah Sherif Radwan Mohamed Salman A. Eraj Andrea Jarre Jay C. Shiao Mona Kamal Subha Perni Jack P. Phan William H. Morrison Steven J. Frank G.Brandon Gunn Adam S. Garden Anita Deswal Jun-ichi Abe David I. Rosenthal Elie Mouhayar Clifton D. Fuller |
| author_facet | Efstratios Koutroumpakis Mohamed A. Naser Abdallah Sherif Radwan Mohamed Salman A. Eraj Andrea Jarre Jay C. Shiao Mona Kamal Subha Perni Jack P. Phan William H. Morrison Steven J. Frank G.Brandon Gunn Adam S. Garden Anita Deswal Jun-ichi Abe David I. Rosenthal Elie Mouhayar Clifton D. Fuller |
| author_sort | Efstratios Koutroumpakis |
| collection | DOAJ |
| description | Aim: This study leveraged standard-of-care CT scans of patients receiving unilateral radiotherapy (RT) for early tonsillar cancer to detect volumetric changes in the carotid arteries, and determine whether there is a dose–response relationship. Methods: Disease-free cancer survivors (>3 months since therapy and age > 18 years) treated with intensity modulated RT for early (T1-2, N0-2b) tonsillar cancer with pre- and post-therapy contrast-enhanced CT scans available were included. Patients treated with definitive surgery, bilateral RT, or additional RT before the post-RT CT scan were excluded. Isodose lines from treatment plans were projected onto both scans, facilitating the delineation of carotid artery subvolumes in 5 Gy increments (i.e. received 50–55 Gy, 55–60 Gy, etc.). The percent-change in sub-volumes across each dose range was examined. Results: Among 46 patients, 72 % received RT alone, 24 % induction chemotherapy followed by RT, and 4 % concurrent chemoradiation. The median interval from RT completion to the latest, post-RT CT scan was 43 months (IQR 32–57). A decrease in the volume of the irradiated carotid artery was observed in 78 % of patients, while there was a statistically significant difference in mean %-change (±SD) between the total irradiated and spared carotid volumes (−7.0 ± 9.0 vs. + 3.5 ± 7.2, respectively, p < 0.0001). Chemotherapy use, in addition to RT, was associated with a significant mean %-decrease in carotid artery volume compared to RT alone. No significant dose–response trend was observed in the carotid artery volume change within 5 Gy ranges. Conclusions: Our data show that standard-of-care oncologic surveillance CT scans can effectively detect reductions in carotid volume following RT for oropharyngeal cancer. Changes were equivalent between studied dose ranges, denoting no further dose–response effect beyond 50 Gy. |
| format | Article |
| id | doaj-art-b62f52de22c44ef1a3f3dc4cffe7ae26 |
| 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-b62f52de22c44ef1a3f3dc4cffe7ae262025-01-30T05:14:29ZengElsevierClinical and Translational Radiation Oncology2405-63082025-03-0151100912Detection of alteration in carotid artery volumetry using standard-of-care computed tomography surveillance scans following unilateral radiation therapy for early-stage tonsillar squamous cell carcinoma survivors: a cross-sectional internally-matched carotid isodose analysisEfstratios Koutroumpakis0Mohamed A. Naser1Abdallah Sherif Radwan Mohamed2Salman A. Eraj3Andrea Jarre4Jay C. Shiao5Mona Kamal6Subha Perni7Jack P. Phan8William H. Morrison9Steven J. Frank10G.Brandon Gunn11Adam S. Garden12Anita Deswal13Jun-ichi Abe14David I. Rosenthal15Elie Mouhayar16Clifton D. Fuller17Department of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd # 1451, Houston, TX 77030, USA; Corresponding authors.Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA; Corresponding authors.Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA; Department of Radiation Oncology, Baylor College of Medicine, Houston, TX, USADepartment of Radiation Oncology, City of Hope Atlanta, Atlanta, GA, USADepartment of Radiology, München Klinik Bogenhausen, Munich, DE, GermanyDepartment of Radiation Oncology, The University of Kansas Cancer Center, Kansas City, KS, USADepartment of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USADepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USADepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USADepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USADepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USADepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USADepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USADepartment of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd # 1451, Houston, TX 77030, USADepartment of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd # 1451, Houston, TX 77030, USADepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USADepartment of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd # 1451, Houston, TX 77030, USADepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA; Corresponding authors.Aim: This study leveraged standard-of-care CT scans of patients receiving unilateral radiotherapy (RT) for early tonsillar cancer to detect volumetric changes in the carotid arteries, and determine whether there is a dose–response relationship. Methods: Disease-free cancer survivors (>3 months since therapy and age > 18 years) treated with intensity modulated RT for early (T1-2, N0-2b) tonsillar cancer with pre- and post-therapy contrast-enhanced CT scans available were included. Patients treated with definitive surgery, bilateral RT, or additional RT before the post-RT CT scan were excluded. Isodose lines from treatment plans were projected onto both scans, facilitating the delineation of carotid artery subvolumes in 5 Gy increments (i.e. received 50–55 Gy, 55–60 Gy, etc.). The percent-change in sub-volumes across each dose range was examined. Results: Among 46 patients, 72 % received RT alone, 24 % induction chemotherapy followed by RT, and 4 % concurrent chemoradiation. The median interval from RT completion to the latest, post-RT CT scan was 43 months (IQR 32–57). A decrease in the volume of the irradiated carotid artery was observed in 78 % of patients, while there was a statistically significant difference in mean %-change (±SD) between the total irradiated and spared carotid volumes (−7.0 ± 9.0 vs. + 3.5 ± 7.2, respectively, p < 0.0001). Chemotherapy use, in addition to RT, was associated with a significant mean %-decrease in carotid artery volume compared to RT alone. No significant dose–response trend was observed in the carotid artery volume change within 5 Gy ranges. Conclusions: Our data show that standard-of-care oncologic surveillance CT scans can effectively detect reductions in carotid volume following RT for oropharyngeal cancer. Changes were equivalent between studied dose ranges, denoting no further dose–response effect beyond 50 Gy.http://www.sciencedirect.com/science/article/pii/S2405630825000023Radiation therapyRadiation-induced carotid artery diseaseCarotid artery volumetryComputed tomographyTonsillar cancerHead and neck cancer |
| spellingShingle | Efstratios Koutroumpakis Mohamed A. Naser Abdallah Sherif Radwan Mohamed Salman A. Eraj Andrea Jarre Jay C. Shiao Mona Kamal Subha Perni Jack P. Phan William H. Morrison Steven J. Frank G.Brandon Gunn Adam S. Garden Anita Deswal Jun-ichi Abe David I. Rosenthal Elie Mouhayar Clifton D. Fuller Detection of alteration in carotid artery volumetry using standard-of-care computed tomography surveillance scans following unilateral radiation therapy for early-stage tonsillar squamous cell carcinoma survivors: a cross-sectional internally-matched carotid isodose analysis Clinical and Translational Radiation Oncology Radiation therapy Radiation-induced carotid artery disease Carotid artery volumetry Computed tomography Tonsillar cancer Head and neck cancer |
| title | Detection of alteration in carotid artery volumetry using standard-of-care computed tomography surveillance scans following unilateral radiation therapy for early-stage tonsillar squamous cell carcinoma survivors: a cross-sectional internally-matched carotid isodose analysis |
| title_full | Detection of alteration in carotid artery volumetry using standard-of-care computed tomography surveillance scans following unilateral radiation therapy for early-stage tonsillar squamous cell carcinoma survivors: a cross-sectional internally-matched carotid isodose analysis |
| title_fullStr | Detection of alteration in carotid artery volumetry using standard-of-care computed tomography surveillance scans following unilateral radiation therapy for early-stage tonsillar squamous cell carcinoma survivors: a cross-sectional internally-matched carotid isodose analysis |
| title_full_unstemmed | Detection of alteration in carotid artery volumetry using standard-of-care computed tomography surveillance scans following unilateral radiation therapy for early-stage tonsillar squamous cell carcinoma survivors: a cross-sectional internally-matched carotid isodose analysis |
| title_short | Detection of alteration in carotid artery volumetry using standard-of-care computed tomography surveillance scans following unilateral radiation therapy for early-stage tonsillar squamous cell carcinoma survivors: a cross-sectional internally-matched carotid isodose analysis |
| title_sort | detection of alteration in carotid artery volumetry using standard of care computed tomography surveillance scans following unilateral radiation therapy for early stage tonsillar squamous cell carcinoma survivors a cross sectional internally matched carotid isodose analysis |
| topic | Radiation therapy Radiation-induced carotid artery disease Carotid artery volumetry Computed tomography Tonsillar cancer Head and neck cancer |
| url | http://www.sciencedirect.com/science/article/pii/S2405630825000023 |
| work_keys_str_mv | AT efstratioskoutroumpakis detectionofalterationincarotidarteryvolumetryusingstandardofcarecomputedtomographysurveillancescansfollowingunilateralradiationtherapyforearlystagetonsillarsquamouscellcarcinomasurvivorsacrosssectionalinternallymatchedcarotidisodoseanalysis AT mohamedanaser detectionofalterationincarotidarteryvolumetryusingstandardofcarecomputedtomographysurveillancescansfollowingunilateralradiationtherapyforearlystagetonsillarsquamouscellcarcinomasurvivorsacrosssectionalinternallymatchedcarotidisodoseanalysis AT abdallahsherifradwanmohamed detectionofalterationincarotidarteryvolumetryusingstandardofcarecomputedtomographysurveillancescansfollowingunilateralradiationtherapyforearlystagetonsillarsquamouscellcarcinomasurvivorsacrosssectionalinternallymatchedcarotidisodoseanalysis AT salmanaeraj detectionofalterationincarotidarteryvolumetryusingstandardofcarecomputedtomographysurveillancescansfollowingunilateralradiationtherapyforearlystagetonsillarsquamouscellcarcinomasurvivorsacrosssectionalinternallymatchedcarotidisodoseanalysis AT andreajarre detectionofalterationincarotidarteryvolumetryusingstandardofcarecomputedtomographysurveillancescansfollowingunilateralradiationtherapyforearlystagetonsillarsquamouscellcarcinomasurvivorsacrosssectionalinternallymatchedcarotidisodoseanalysis AT jaycshiao detectionofalterationincarotidarteryvolumetryusingstandardofcarecomputedtomographysurveillancescansfollowingunilateralradiationtherapyforearlystagetonsillarsquamouscellcarcinomasurvivorsacrosssectionalinternallymatchedcarotidisodoseanalysis AT monakamal detectionofalterationincarotidarteryvolumetryusingstandardofcarecomputedtomographysurveillancescansfollowingunilateralradiationtherapyforearlystagetonsillarsquamouscellcarcinomasurvivorsacrosssectionalinternallymatchedcarotidisodoseanalysis AT subhaperni detectionofalterationincarotidarteryvolumetryusingstandardofcarecomputedtomographysurveillancescansfollowingunilateralradiationtherapyforearlystagetonsillarsquamouscellcarcinomasurvivorsacrosssectionalinternallymatchedcarotidisodoseanalysis AT jackpphan detectionofalterationincarotidarteryvolumetryusingstandardofcarecomputedtomographysurveillancescansfollowingunilateralradiationtherapyforearlystagetonsillarsquamouscellcarcinomasurvivorsacrosssectionalinternallymatchedcarotidisodoseanalysis AT williamhmorrison detectionofalterationincarotidarteryvolumetryusingstandardofcarecomputedtomographysurveillancescansfollowingunilateralradiationtherapyforearlystagetonsillarsquamouscellcarcinomasurvivorsacrosssectionalinternallymatchedcarotidisodoseanalysis AT stevenjfrank detectionofalterationincarotidarteryvolumetryusingstandardofcarecomputedtomographysurveillancescansfollowingunilateralradiationtherapyforearlystagetonsillarsquamouscellcarcinomasurvivorsacrosssectionalinternallymatchedcarotidisodoseanalysis AT gbrandongunn detectionofalterationincarotidarteryvolumetryusingstandardofcarecomputedtomographysurveillancescansfollowingunilateralradiationtherapyforearlystagetonsillarsquamouscellcarcinomasurvivorsacrosssectionalinternallymatchedcarotidisodoseanalysis AT adamsgarden detectionofalterationincarotidarteryvolumetryusingstandardofcarecomputedtomographysurveillancescansfollowingunilateralradiationtherapyforearlystagetonsillarsquamouscellcarcinomasurvivorsacrosssectionalinternallymatchedcarotidisodoseanalysis AT anitadeswal detectionofalterationincarotidarteryvolumetryusingstandardofcarecomputedtomographysurveillancescansfollowingunilateralradiationtherapyforearlystagetonsillarsquamouscellcarcinomasurvivorsacrosssectionalinternallymatchedcarotidisodoseanalysis AT junichiabe detectionofalterationincarotidarteryvolumetryusingstandardofcarecomputedtomographysurveillancescansfollowingunilateralradiationtherapyforearlystagetonsillarsquamouscellcarcinomasurvivorsacrosssectionalinternallymatchedcarotidisodoseanalysis AT davidirosenthal detectionofalterationincarotidarteryvolumetryusingstandardofcarecomputedtomographysurveillancescansfollowingunilateralradiationtherapyforearlystagetonsillarsquamouscellcarcinomasurvivorsacrosssectionalinternallymatchedcarotidisodoseanalysis AT eliemouhayar detectionofalterationincarotidarteryvolumetryusingstandardofcarecomputedtomographysurveillancescansfollowingunilateralradiationtherapyforearlystagetonsillarsquamouscellcarcinomasurvivorsacrosssectionalinternallymatchedcarotidisodoseanalysis AT cliftondfuller detectionofalterationincarotidarteryvolumetryusingstandardofcarecomputedtomographysurveillancescansfollowingunilateralradiationtherapyforearlystagetonsillarsquamouscellcarcinomasurvivorsacrosssectionalinternallymatchedcarotidisodoseanalysis |