Radiation dose to the masseter and medial pterygoid muscle in relation to trismus after chemoradiotherapy for advanced head and neck cancer

S.A. Kraaijenga; O. Hamming-Vrieze; S. Verheijen; E. Lamers; L. van der Molen; F.J. Hilgers; M.W. van den Brekel; W.D. Heemsbergen

doi:10.1002/hed.25573

Radiation dose to the masseter and medial pterygoid muscle in relation to trismus after chemoradiotherapy for advanced head and neck cancer

S.A. Kraaijenga, O. Hamming-Vrieze, S. Verheijen, E. Lamers, L. van der Molen, F.J. Hilgers, M.W. van den Brekel, W.D. Heemsbergen

Maxillofacial Surgery (AMC)

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Background: We studied the relationship between trismus (maximum interincisor opening [MIO] ≤35 mm) and the dose to the ipsilateral masseter muscle (iMM) and ipsilateral medial pterygoid muscle (iMPM). Methods: Pretreatment and post-treatment measurement of MIO at 13 weeks revealed 17% of trismus cases in 83 patients treated with chemoradiation and intensity-modulated radiation therapy. Logistic regression models were fitted with dose parameters of the iMM and iMPM and baseline MIO (bMIO). A risk classification tree was generated to obtain optimal cut-off values and risk groups. Results: Dose levels of iMM and iMPM were highly correlated due to proximity. Both iMPM and iMM dose parameters were predictive for trismus, especially mean dose and intermediate dose volume parameters. Adding bMIO, significantly improved Normal Tissue Complication Probability (NTCP) models. Optimal cutoffs were 58 Gy (mean dose iMPM), 22 Gy (mean dose iMM) and 46 mm (bMIO). Conclusions: Both iMPM and iMM doses, as well as bMIO, are clinically relevant parameters for trismus prediction.

Original language	English
Pages (from-to)	1387-1394
Number of pages	8
Journal	Head and Neck
Volume	41
Issue number	5
DOIs	https://doi.org/10.1002/hed.25573
Publication status	Published - May 2019

Funding

Atos Medical, Grant/Award Number: general research grant to support Quality of Life research; Stichting De Hoop, Grant/Award Number: general research grant to support Quality of Life research. The authors would like to acknowledge M. Jonker and J. B. van de Kamer for their contribution to the development of the research protocol. The authors acknowledge Atos Medical (Sweden) and “Stichting de Hoop” (The Netherlands) for their research grant, which contributes to the existing infrastructure for health-related quality of life research of the Department of Head and Neck Oncology and Surgery. They had no involvement in study design, analysis, interpretation, and writing of the manuscript.

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Stichting de Hoop

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@article{1592ae9311a84a7895b33e626e42927c,

title = "Radiation dose to the masseter and medial pterygoid muscle in relation to trismus after chemoradiotherapy for advanced head and neck cancer",

abstract = "Background: We studied the relationship between trismus (maximum interincisor opening [MIO] ≤35 mm) and the dose to the ipsilateral masseter muscle (iMM) and ipsilateral medial pterygoid muscle (iMPM). Methods: Pretreatment and post-treatment measurement of MIO at 13 weeks revealed 17% of trismus cases in 83 patients treated with chemoradiation and intensity-modulated radiation therapy. Logistic regression models were fitted with dose parameters of the iMM and iMPM and baseline MIO (bMIO). A risk classification tree was generated to obtain optimal cut-off values and risk groups. Results: Dose levels of iMM and iMPM were highly correlated due to proximity. Both iMPM and iMM dose parameters were predictive for trismus, especially mean dose and intermediate dose volume parameters. Adding bMIO, significantly improved Normal Tissue Complication Probability (NTCP) models. Optimal cutoffs were 58 Gy (mean dose iMPM), 22 Gy (mean dose iMM) and 46 mm (bMIO). Conclusions: Both iMPM and iMM doses, as well as bMIO, are clinically relevant parameters for trismus prediction.",

author = "S.A. Kraaijenga and O. Hamming-Vrieze and S. Verheijen and E. Lamers and {van der Molen}, L. and F.J. Hilgers and {van den Brekel}, M.W. and W.D. Heemsbergen",

year = "2019",

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doi = "10.1002/hed.25573",

language = "English",

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T1 - Radiation dose to the masseter and medial pterygoid muscle in relation to trismus after chemoradiotherapy for advanced head and neck cancer

AU - Kraaijenga, S.A.

AU - Hamming-Vrieze, O.

AU - Verheijen, S.

AU - Lamers, E.

AU - van der Molen, L.

AU - Hilgers, F.J.

AU - van den Brekel, M.W.

AU - Heemsbergen, W.D.

PY - 2019/5

Y1 - 2019/5

N2 - Background: We studied the relationship between trismus (maximum interincisor opening [MIO] ≤35 mm) and the dose to the ipsilateral masseter muscle (iMM) and ipsilateral medial pterygoid muscle (iMPM). Methods: Pretreatment and post-treatment measurement of MIO at 13 weeks revealed 17% of trismus cases in 83 patients treated with chemoradiation and intensity-modulated radiation therapy. Logistic regression models were fitted with dose parameters of the iMM and iMPM and baseline MIO (bMIO). A risk classification tree was generated to obtain optimal cut-off values and risk groups. Results: Dose levels of iMM and iMPM were highly correlated due to proximity. Both iMPM and iMM dose parameters were predictive for trismus, especially mean dose and intermediate dose volume parameters. Adding bMIO, significantly improved Normal Tissue Complication Probability (NTCP) models. Optimal cutoffs were 58 Gy (mean dose iMPM), 22 Gy (mean dose iMM) and 46 mm (bMIO). Conclusions: Both iMPM and iMM doses, as well as bMIO, are clinically relevant parameters for trismus prediction.

AB - Background: We studied the relationship between trismus (maximum interincisor opening [MIO] ≤35 mm) and the dose to the ipsilateral masseter muscle (iMM) and ipsilateral medial pterygoid muscle (iMPM). Methods: Pretreatment and post-treatment measurement of MIO at 13 weeks revealed 17% of trismus cases in 83 patients treated with chemoradiation and intensity-modulated radiation therapy. Logistic regression models were fitted with dose parameters of the iMM and iMPM and baseline MIO (bMIO). A risk classification tree was generated to obtain optimal cut-off values and risk groups. Results: Dose levels of iMM and iMPM were highly correlated due to proximity. Both iMPM and iMM dose parameters were predictive for trismus, especially mean dose and intermediate dose volume parameters. Adding bMIO, significantly improved Normal Tissue Complication Probability (NTCP) models. Optimal cutoffs were 58 Gy (mean dose iMPM), 22 Gy (mean dose iMM) and 46 mm (bMIO). Conclusions: Both iMPM and iMM doses, as well as bMIO, are clinically relevant parameters for trismus prediction.

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DO - 10.1002/hed.25573

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SN - 1043-3074

VL - 41

SP - 1387

EP - 1394

JO - Head and Neck

JF - Head and Neck

IS - 5

ER -

Radiation dose to the masseter and medial pterygoid muscle in relation to trismus after chemoradiotherapy for advanced head and neck cancer

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