June 11th, 2021
Purpose: To determine whether patient similarity in terms of head and neck cancer spread through lymph nodes correlates significantly with radiation-associated toxicity.
Materials and methods: 582 head and neck cancer patients received radiotherapy for oropharyngeal cancer (OPC) and had non-metastatic affected lymph nodes in the head and neck. Affected lymph nodes were segmented from pretreatment contrast-enhanced tomography scans and categorized according to consensus guidelines. Similar patients were clustered into 4 groups according to a graph-based representation of disease spread through affected lymph nodes. Correlation between dysphagia-associated symptoms and patient groups was calculated.
Results: Out of 582 patients, 26% (152) experienced toxicity during a follow-up evaluation 6 months after completion of radiotherapy treatment. Patient groups identified by our approach were significantly correlated with dysphagia, feeding tube, and aspiration toxicity (p < .0005).
Discussion: Our results suggest that structural geometry-aware characterization of affected lymph nodes can be used to better predict radiation-associated dysphagia at time of diagnosis, and better inform treatment guidelines.
Conclusion: Our work successfully stratified a patient cohort into similar groups using a structural geometry, graph-encoding of affected lymph nodes in oropharyngeal cancer patients, that were predictive of late radiation-associated dysphagia and toxicity.
Wentzel, A., Luciani, T., van Dijk, L., Taku, N., Elgohari, B., Mohamed, A.S.R., Canahuate, G., Fuller, C.D., Vock, D., Marai, G.E., Precision association of lymphatic disease spread with radiation-associated toxicity in oropharyngeal squamous carcinomas, Radiotherapy and Oncology, vol 161, Elsevier, pp. 152–158, June 11th, 2021. https://doi.org/10.1016/j.radonc.2021.06.016