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14.07.2022 | Original Article

Intensity-modulated radiotherapy does not induce volumetric changes of the Bichat fat pad in nasopharyngeal cancer

verfasst von: Alberto Cacciola, MD, Sara Lillo, MD, Silvana Parisi, MD, Consuelo Tamburella, MD, Anna Brogna, MSc, Gianluca Ferini, MD, Alfredo Blandino, MD, Fabio Minutoli, MD, Stefano Pergolizzi, MD

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 11/2022

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Abstract

Purpose

To evaluate morphological and functional changes in the Bichat fat pad (BFP) after curative concurrent chemoradiotherapy in nasopharyngeal cancer (NPC) patients.

Methods

We retrospectively analyzed the volumetric, metabolic, and dosimetry parameters of BFPs in 7 NPC patients who underwent intensity-modulated radiotherapy (IMRT) between 2015 and 2020. Inclusion criteria were i) histologically confirmed diagnosis of NPC, ii) follow-up period of at least 12 months, iii) no history of previous irradiation or surgery in the maxillofacial area, and ìv) availability of pre- and posttreatment MRI and ¹⁸F‑FDG PET-CT performed in our Institution. All patients had stage III–IVA disease (n = 7) and received platinum-based chemotherapy. Planned doses in 30 daily fractions/5 days per week were 66 Gy (2.2 Gy/die 5 days/week) to the gross tumor volume, 66 Gy (2.1–2.2 Gy/die 5 days/week) to the gross nodal volume, 60 Gy (2 Gy/die 5 days week) to clinical target volume (CTV)1, and 54 Gy (1.8 Gy/die 5 days/week) to CTV2. All patients completed the planned radiotherapy course in a median time of 42 days (range 42–43). Relationships between BFP volumes and the following DVH parameters were evaluated: mean dose, maximum dose (Dmax), and percentage of BFP volume receiving more than 5 to 65 Gy (V5 to V65).

Results

The pre-RT volumes of the left and right BFPs were 12.24 cc (range 6.51–20.01 cc) and 11.55 cc (range 5.78–17.53 cc), respectively. The mean volumes of left BFP_PRE and BFP_POST were 12.24 cc (range 6.51–20.01cc) and 13.85 cc (range 7.54–20.21 cc), respectively, with no significant statistical differences (P > 0.05). No statistically significant correlations were found between dosimetry features and BFP volumetric changes (all P > 0.05).

Conclusion

Our original results showed that chemoradiotherapy does not induce significant volumetric changes of the BFP. Further investigations are needed to evaluate the effects of higher radiation doses on BFP. This is the first real-world study on this issue.

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Titel: Intensity-modulated radiotherapy does not induce volumetric changes of the Bichat fat pad in nasopharyngeal cancer
verfasst von: Alberto Cacciola, MD
Sara Lillo, MD
Silvana Parisi, MD
Consuelo Tamburella, MD
Anna Brogna, MSc
Gianluca Ferini, MD
Alfredo Blandino, MD
Fabio Minutoli, MD
Stefano Pergolizzi, MD
Publikationsdatum: 14.07.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 11/2022
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-022-01974-7

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Intensity-modulated radiotherapy does not induce volumetric changes of the Bichat fat pad in nasopharyngeal cancer