IMPACT OF HOMOGENEITY INDEX ON RESPONSE RATE AND SURVIVAL IN HEAD AND NECK CANCER PATIENTS TREATED WITH IMRT
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 1
Abstract
BACKGROUND Homogeneity Index (HI) is a measurement used in conformal radiotherapy to evaluate the uniformity of dose distribution in the treatment volume. There are many controversies existing in the clinical usage of Homogeneity Index like the ideal formula to be used to calculate it, which type of radiotherapy (3DCRT/IMRT/SRS) can be evaluated using HI and what its clinical implication is. Even though the ultimate aim of radiation treatment is to improve local control and survival of the patient, there is scarcity of literature as to whether Homogeneity Index has any direct impact on patient survival MATERIALS AND METHODS This retrospective cohort study of 50 patients with head and neck tumours were treated with radical IMRT with concurrent chemotherapy were retrospectively analyzed. Homogeneity Index was calculated using 5 standard formulas and each was correlated with 3-month response rates and local recurrence free survival. Cox regression analysis and multivariate analysis were done to assess the survival and response rates respectively. RESULTS When analyzed together, none of the homogeneity indices showed any direct impact on survival or response rates in patients which were statistically significant. But subgroup analysis showed that when divided into sub sites, the homogeneity index calculated by (D5-D95)/Dp was statistically significant in predicting the local recurrence free survival. The impact of the value on survival when divided into individual sub sites were not analyzed as the sample size was too low. CONCLUSION HI calculated in this study by D5-D95/Dp seems to be the most statistically significant in predicting the local recurrence rates. But the real clinical impact of Homogeneity Index as a clinically important value still remains doubtful and it still does not warrant the status of a standalone value to evaluate plans.
Authors and Affiliations
Flowerlit Thomas, Suresh Kumar K, Mintu Mathew, Kiran P
Keywords
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- EP ID EP553049
- DOI 10.14260/jemds/2019/14
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