Dosimetric evaluation of dorsal vagal complex and vestibular apparatus in head-and-neck cancer patients treated with intensity-modulated radiotherapy

Abstract

Purpose: The purpose of this study was to dosimetrically evaluate the dose received by dorsal vagal complex (DVC) and vestibular apparatus in patients with head-and-neck cancer treated with intensity-modulated radiotherapy (IMRT). Materials and Methods: Twenty histopathologically confirmed head-and-neck cancer patients, preferably oropharynx and nasopharynx that were treated with IMRT from a period of 2018–2020, were retrospectively analyzed in this study. DVC and vestibular apparatus were contoured, and the doses received by them were noted. Results: The average minimum dose to the entire DVC and vestibular apparatus was 25.134 Gy (range, 8.77–37.49 Gy) and 12.812 Gy (range, 1.07–28.57 Gy); the average maximum point dose to the DVC and vestibular apparatus was 35.896 Gy (range, 24.29–45.53 Gy) and 33.266 Gy (range, 3.19–60.72 Gy); and the average mean dose to the entire DVC and vestibular apparatus volume was 30.151 Gy (range, 16.48–40.83 Gy) and 21.484 Gy (range, 2.99–39.42 Gy), respectively; the average volume of DVC and vestibular apparatus was 0.52 cm3 (range, 0.3–0.8 cm3) and 0.36 (range, 0.2–0.6 cm3), respectively. Conclusions: Considering the DVC and vestibular apparatus as an organ for conformal avoidance, there can be a possibility in the reduction of nausea and vomiting while treating patients of head-and-neck cancer with radiation.

Keywords

• dorsal vagal complex
• emetic centers
• radiation-induced nausea and vomiting