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Brainstem dose is associated with patient-reported acute fatigue in head and neck cancer radiation therapy.


ABSTRACT: BACKGROUND AND PURPOSE:Radiation (RT) dose to the central nervous system (CNS) has been implicated as a contributor to treatment-related fatigue in head and neck cancer (HNC) patients undergoing radiation therapy (RT). This study evaluates the association of RT dose to CNS structures with patient-reported (PRO) fatigue scores in a population of HNC patients. MATERIALS AND METHODS:At pre-RT (baseline), 6th week of RT, and 1-month post-RT time points, Multidimensional Fatigue Inventory (MFI-20) scores were prospectively obtained from 124 patients undergoing definitive treatment for HNC. Medulla, pons, midbrain, total brainstem, cerebellum, posterior fossa, and pituitary dosimetry were evaluated using summary statistics and dose-volume histograms, and associations with MFI-20 scores were analyzed. RESULTS:Maximum dose (Dmax) to the brainstem and medulla was significantly associated with MFI-20 scores at 6th week of RT and 1-month post-RT time points, after controlling for baseline scores (p<0.05). Each 1Gy increase in medulla Dmax resulted in an increase in total MFI-20 score over baseline of 0.30 (p=0.026), and 0.25 (p=0.037), at the 6th week of RT and 1-month post-RT, respectively. Each 1Gy increase in brainstem Dmax resulted in an increase in total MFI-20 score over baseline of 0.30 (p=0.027), and 0.25 (p=0.037) at the 6th week of RT, 1-month post-RT, respectively. Statistically significant associations were not found between dosimetry for the other CNS structures and MFI-20 scores. CONCLUSIONS:In this analysis of PRO fatigue scores from a population of patients undergoing definitive RT for HNC, maximum dose to the brainstem and medulla was associated with a significantly increased risk of acute patient fatigue.

SUBMITTER: Ferris MJ 

PROVIDER: S-EPMC5841457 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Brainstem dose is associated with patient-reported acute fatigue in head and neck cancer radiation therapy.

Ferris Matthew J MJ   Zhong Jim J   Switchenko Jeffrey M JM   Higgins Kristin A KA   Cassidy Richard J RJ   McDonald Mark W MW   Eaton Bree R BR   Patel Kirtesh R KR   Steuer Conor E CE   Baddour H Michael HM   Miller Andrew H AH   Bruner Deborah W DW   Xiao Canhua C   Beitler Jonathan J JJ  

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology 20170818 1


<h4>Background and purpose</h4>Radiation (RT) dose to the central nervous system (CNS) has been implicated as a contributor to treatment-related fatigue in head and neck cancer (HNC) patients undergoing radiation therapy (RT). This study evaluates the association of RT dose to CNS structures with patient-reported (PRO) fatigue scores in a population of HNC patients.<h4>Materials and methods</h4>At pre-RT (baseline), 6th week of RT, and 1-month post-RT time points, Multidimensional Fatigue Invent  ...[more]

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