Radiation-induced changes in volume and CT number of gross tumour volume and parotid glands during the course of IMRT for head and neck cancers

Abstract

Introduction. The CT number (CTN) for tumours and organs at risk can change with radiation therapy, which can be an early indicator for radiation response. This study investigates the correlation of radiation-induced changes in volume and CTN in gross tumour volume (GTV) and parotid glands (PG) during the course of intensity-modulated radiation therapy (IMRT) in head and neck cancers (HNC). Materials and methods. Re-CT scans were acquired at four weeks for 71 patients with stage II IVb HNC treated with chemoradiation. The changes in volumes and CTN of the GTV primary, GTV node, and PG at four weeks of radiation were analysed. Pearson’s correlation was used to assess any association between CTN change and volume reduction of the GTVs and PGs. Results. The volumes of the GTVs and the ipsilateral PG and contralateral PG were reduced during the course of the radiation therapy after four weeks with mean volume shrinkage of 26.30 ± 7.66 (p < 0.0001), 32.09 ± 37.2 (p < 0.04), 8.38 ± 1.61 (p < 0.0001), and 9.10 ± 1.81 cm3 (p < 0.0001), respectively, and the mean CTN reduced by 2.50 ± 5.4, 1.79 ± 4.12, 1.90 ± 3.57, and 1.99 ± 3.54 HUs, respectively. For GTVs, the CTN and GTV volume decreases were found to be positively correlated, but the relationship was weak. However, no noticeable correlation was observed between the CTN change and the volume change in both PGs. Conclusions. The CTN changes in GTVs and PGs during delivery of radiation for HNC are measurable and patient specific. The CTN can be reduced in GTVs and PGs with a reasonable correlation between the mean CTN and volume reductions in GTVs, but with no correlation with PGs.