カワムラ　ヒデマサ   KAWAMURA Hidemasa   河村　英将    所属   埼玉医科大学  医学部 総合医療センター　放射線科(画像診断・核医学科、放射線腫瘍科)    職種   教授
論文種別	学術雑誌(原著)
言語種別	英語
査読の有無	査読あり
表題	Dosimetric parameters predictive of nasolacrimal duct obstruction after carbon-ion radiotherapy for head and neck carcinoma.
掲載誌名	正式名：Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology ISSNコード：0167-8140
掲載区分	国外
巻・号・頁	141,72-77頁
著者・共著者	Nobuteru Kubo,Yoshiki Kubota,Hidemasa Kawamura,Takahiro Oike,Makoto Sakai,Takuya Kumazawa,Yuhei Miyasaka,Shohei Okazaki,Daijiro Kobayashi,Hiro Sato,Tatsuji Mizukami,Atsushi Musha,Katsuyuki Shirai,Jun-Ichi Saitoh,Satoshi Yokoo,Kazuaki Chikamatsu,Tatsuya Ohno,Takashi Nakano
発行年月	2019/12
概要	BACKGROUND AND PURPOSE: Little information is available on the risk factors for nasolacrimal duct obstruction after radiotherapy for head and neck tumors. We investigated the incidence and predictive dosimetric parameters for nasolacrimal duct obstruction following carbon-ion radiotherapy for head and neck tumors. MATERIALS AND METHODS: Twenty-eight patients with head and neck non-squamous cell carcinoma were analyzed in this single-institution prospective study. More than half of the tumors were located in the nasal cavity and maxillary sinus. Carbon-ion radiotherapy consisting of 57.6 or 64.0 Gy(relative biological effectiveness; RBE) in 16 fractions was administered. Nasolacrimal duct obstruction was recorded according to Common Terminology Criteria for Adverse Events version 4.0. Cutoff values were determined using receiver operating characteristic (ROC) curve analysis. VX indicates the volume irradiated with X Gy(RBE). RESULTS: The median follow-up period was 60.3 months. Incidences of Grade 1 and 2 nasolacrimal duct obstructions were 46% (13/28) and 7% (2/28), respectively; no Grade 3 or greater toxicities were recorded. Throughout the dose range, the volumes of the irradiated nasolacrimal ducts were significantly higher in the obstruction-positive patients than in the obstruction-negative patients (p < 0.001 for V10, V20, V30, V40, V50, and V60). Cutoff values determined by the ROC curve analysis classified the obstruction-positive patients with an accuracy of >96% over the entire range of V10-V60. CONCLUSION: The incidence and predictive dosimetric parameters for nasolacrimal duct obstruction after carbon-ion radiotherapy were demonstrated in a prospective cohort. These data should help optimize carbon-ion radiotherapy treatments for patients with head and neck tumors.
DOI	10.1016/j.radonc.2019.07.022
PMID	31439449