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A multi-center survey on adaptive radiation therapy for head and neck cancer in Malaysia

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Abstract

The survey is to assess the current state of adaptive radiation therapy (ART) for head and neck (H&N) cases among radiotherapy centers in Malaysia and to identify any implementation limitations. An online questionnaire was sent to all radiotherapy centers in Malaysia. The 24-question questionnaire consists of general information about the center, ART practices, and limitations faced in implementing ART. 28 out of 36 radiotherapy centers responded, resulting in an overall response rate of 78%. About 52% of the responding centers rescanned and replanned less than 5% of their H&N patients. The majority (88.9%) of the respondents reported the use Cone Beam Computed Tomography alone or in combination with other modalities to trigger the ART process. The main reasons cited for adopting ART were weight loss, changes in the immobilization fitting, and anatomical variation. The adaptation process typically occurred during week 3 or week 4 of treatment. More than half of the respondents require three days or more from re-simulation to starting a new treatment plan. Both target and organ at risk delineation on new planning CT relied heavily on manual delineation by physicians and physicists, respectively. All centers perform patient-specific quality assurance for their new adaptive plans. Two main limitations in implementing ART are “limited financial resources or equipment” and “limitation on technical knowledge”. There is a need for a common consensus to standardize the practice of ART and address these limitations to improve the implementation of ART in Malaysia.

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References

  1. Yan D, Vicini F, Wong J, Martinez A (1997) Adaptive radiation therapy. Phys Med Biol 42:123–132. https://doi.org/10.1088/0031-9155/42/1/008

    Article  CAS  PubMed  Google Scholar 

  2. Morgan HE, Sher DJ (2020) Adaptive radiotherapy for head and neck cancer. Cancers Head Neck 5:1. https://doi.org/10.1186/s41199-019-0046-z

    Article  PubMed Central  PubMed  Google Scholar 

  3. Brock KK (2019) Adaptive radiotherapy: moving into the future. Semin Radiat Oncol 29:181–184. https://doi.org/10.1016/j.semradonc.2019.02.011

    Article  PubMed Central  PubMed  Google Scholar 

  4. Heukelom J, Fuller CD (2019) Head and neck cancer adaptive radiation therapy (ART): conceptual considerations for the informed clinician. Semin Radiat Oncol 29:258–273. https://doi.org/10.1016/j.semradonc.2019.02.008

    Article  PubMed Central  PubMed  Google Scholar 

  5. Sonke J-J, Aznar M, Rasch C (2019) Adaptive radiotherapy for anatomical changes. Sem Radiat Oncol 29:245–57. https://doi.org/10.1016/j.semradonc.2019.02.007

    Article  Google Scholar 

  6. Lacas B, Bourhis J, Overgaard J, Zhang Q, Gregoire V, Nankivell M et al (2017) Role of radiotherapy fractionation in head and neck cancers (MARCH): an updated meta-analysis. Lancet Oncol 18:1221–1237. https://doi.org/10.1016/S1470-2045(17)30458-8

    Article  PubMed Central  PubMed  Google Scholar 

  7. Phua CE, Tan BS, Tan AL, Eng KY, Ng BS, Malik RA et al (2012) Intensity-modulated radiotherapy for nasopharyngeal carcinoma: Penang General Hospital experience. Asian Pac J Cancer Prev 13:3287–3292. https://doi.org/10.7314/apjcp.2012.13.7.3287

    Article  PubMed  Google Scholar 

  8. Castelli J, Simon A, Lafond C, Perichon N, Rigaud B, Chajon E et al (2018) Adaptive radiotherapy for head and neck cancer. Acta Oncol 57:1284–1292. https://doi.org/10.1080/0284186X.2018.1505053

    Article  CAS  PubMed  Google Scholar 

  9. Figen M, Colpan Oksuz D, Duman E, Prestwich R, Dyker K, Cardale K et al (2020) Radiotherapy for head and neck cancer: evaluation of triggered adaptive replanning in routine practice. Front Oncol 10:579917. https://doi.org/10.3389/fonc.2020.579917

    Article  PubMed Central  PubMed  Google Scholar 

  10. Castadot P, Lee JA, Geets X, Gregoire V (2010) Adaptive radiotherapy of head and neck cancer. Semin Radiat Oncol 20:84–93. https://doi.org/10.1016/j.semradonc.2009.11.002

    Article  PubMed  Google Scholar 

  11. Global Cancer Observatory: Malaysia Globocan 2020 (2021) Lyon, France: International Agency for Research on Cancer. https://gco.iarc.fr/today/data/factsheets/populations/458-malaysia-fact-sheets.pdf. Accessed 28 Oct 2022

  12. Wong YF, Yusof MM, Wan Ishak WZ, Alip A, Phua VC (2015) Treatment outcome for head and neck squamous cell carcinoma in a develo** country: University Malaya Medical Centre, Malaysia from 2003–2010. Asian Pac J Cancer Prev 16:2903–2908. https://doi.org/10.7314/apjcp.2015.16.7.2903

    Article  PubMed  Google Scholar 

  13. Abdullah MM, Foo YC, Yap BK, Lee CML, Hoo LP, Lim TO (2019) Retrospective analysis of cancer care performance and survival outcome for nasopharyngeal carcinoma at a leading Cancer Treatment Centre in Malaysia 2008–2012. Asian Pac J Cancer Prev 20:1701–1708. https://doi.org/10.31557/APJCP.2019.20.6.1701

    Article  PubMed Central  PubMed  Google Scholar 

  14. Rigaud B, Simon A, Castelli J, Gobeli M, Ospina Arango JD, Cazoulat G et al (2015) Evaluation of deformable image registration methods for dose monitoring in head and neck radiotherapy. Biomed Res Int 2015:726268. https://doi.org/10.1155/2015/726268

    Article  PubMed Central  PubMed  Google Scholar 

  15. Castelli J, Simon A, Louvel G, Henry O, Chajon E, Nassef M et al (2015) Impact of head and neck cancer adaptive radiotherapy to spare the parotid glands and decrease the risk of xerostomia. Radiat Oncol 10:6. https://doi.org/10.1186/s13014-014-0318-z

    Article  PubMed Central  PubMed  Google Scholar 

  16. Brouwer CL, Steenbakkers RJ, Langendijk JA, Sijtsema NM (2015) Identifying patients who may benefit from adaptive radiotherapy: does the literature on anatomic and dosimetric changes in head and neck organs at risk during radiotherapy provide information to help? Radiother Oncol 115:285–294. https://doi.org/10.1016/j.radonc.2015.05.018

    Article  PubMed  Google Scholar 

  17. Lee VS, SchettIno G, Nisbet A (2020) UK adaptive radiotherapy practices for head and neck cancer patients. BJR Open 2:20200051. https://doi.org/10.1259/bjro.20200051

    Article  PubMed Central  PubMed  Google Scholar 

  18. Brown E, Owen R, Harden F, Mengersen K, Oestreich K, Houghton W et al (2016) Head and neck adaptive radiotherapy: predicting the time to replan. Asia Pac J Clin Oncol 12:460–467. https://doi.org/10.1111/ajco.12516

    Article  PubMed  Google Scholar 

  19. Ann Barrett JD, Morris S (2009) Practical radiotherapy planning, 4th edn. Taylor & Francis, Abingdon, Oxon, pp 88–110

    Book  Google Scholar 

  20. Kadoya N, Kito S, Kurooka M, Saito M, Takemura A, Tohyama N et al (2019) Factual survey of the clinical use of deformable image registration software for radiotherapy in Japan. J Radiat Res 60:546–553. https://doi.org/10.1093/jrr/rrz034

    Article  PubMed Central  PubMed  Google Scholar 

  21. Krishnatry R, Bhatia J, Murthy V, Agarwal JP (2018) Survey on adaptive radiotherapy practice. Clin Oncol (R Coll Radiol) 30:819. https://doi.org/10.1016/j.clon.2018.08.008

    Article  CAS  PubMed  Google Scholar 

  22. Brouwer CL, Steenbakkers RJ, van der Schaaf A, Sopacua CT, van Dijk LV, Kierkels RG et al (2016) Selection of head and neck cancer patients for adaptive radiotherapy to decrease xerostomia. Radiother Oncol 120:36–40. https://doi.org/10.1016/j.radonc.2016.05.025

    Article  PubMed  Google Scholar 

  23. Tsuji SY, Hwang A, Weinberg V, Yom SS, Quivey JM, **a P (2010) Dosimetric evaluation of automatic segmentation for adaptive IMRT for head-and-neck cancer. Int J Radiat Oncol Biol Phys 77:707–714. https://doi.org/10.1016/j.ijrobp.2009.06.012

    Article  PubMed  Google Scholar 

  24. Schwartz DL (2012) Current progress in adaptive radiation therapy for head and neck cancer. Curr Oncol Rep 14:139–147. https://doi.org/10.1007/s11912-012-0221-4

    Article  CAS  PubMed  Google Scholar 

  25. Rigaud B, Simon A, Castelli J, Lafond C, Acosta O, Haigron P et al (2019) Deformable image registration for radiation therapy: principle, methods, applications and evaluation. Acta Oncol 58:1225–1237. https://doi.org/10.1080/0284186X.2019.1620331

    Article  PubMed  Google Scholar 

  26. Brock KK, Mutic S, McNutt TR, Li H, Kessler ML (2017) Use of image registration and fusion algorithms and techniques in radiotherapy: report of the AAPM Radiation Therapy Committee Task Group No. 132. Med Phys 44:e43–e76. https://doi.org/10.1002/mp.12256

    Article  CAS  PubMed  Google Scholar 

  27. Rong Y, Rosu-Bubulac M, Benedict SH, Cui Y, Ruo R, Connell T et al (2021) Rigid and deformable image registration for radiation therapy: a self-study evaluation guide for NRG Oncology Clinical Trial Participation. Pract Radiat Oncol 11:282–298. https://doi.org/10.1016/j.prro.2021.02.007

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgements

The authors like to thank all respondents who gave their precious time to complete this survey. Special thanks to M. Arunasalam for his constructive comments and review on the survey questionnaire.

Funding

This study was funded by Universiti Malaya Impact Oriented Interdisciplinary Research Grant (IIRG003A-2022HWB).

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Authors and Affiliations

  1. Clinical Oncology Unit, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia

    Lai Mun Yap, Zulaikha Jamalludin, Aik Hao Ng & Ngie Min Ung

  2. Department of Radiotherapy, Aurelius Hospital Nilai, 71800, Nilai, Malaysia

    Lai Mun Yap

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  1. Lai Mun Yap
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  3. Aik Hao Ng
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  4. Ngie Min Ung
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by LMY, ZJ, AHN and NMU. The first draft of the manuscript was written by LMY and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Zulaikha Jamalludin or Ngie Min Ung.

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Yap, L.M., Jamalludin, Z., Ng, A.H. et al. A multi-center survey on adaptive radiation therapy for head and neck cancer in Malaysia. Phys Eng Sci Med 46, 1331–1340 (2023). https://doi.org/10.1007/s13246-023-01303-x

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  • DOI: https://doi.org/10.1007/s13246-023-01303-x

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