Impact of dose volume parameters and clinical factors on acute radiation oral mucositis for locally advanced nasopharyngeal carcinoma patients treated with concurrent intensity-modulated radiation therapy and chemoradiotherapy

Li, Kaixin; Yang, Ling; Xin, Peiling; Chen, Yuanyuan; Hu, Qichang; Chen, Xiao Zhong; Chen, Ming

doi:10.1016/j.oraloncology.2017.06.026

Cited by 26 publications

(32 citation statements)

References 30 publications

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“…Mucositis lesions are often extremely painful and may lead to oral discomfort, inadequate intake of food and medications, delays in cancer treatment, longer hospitalization time and consequently more costs and higher risk of life‐threatening infection . These complications may limit the patient's ability to tolerate an optimal antineoplastic treatment, which can negatively impact treatment planning and prognosis . It is therefore critical that mucositis can be prevented or treated to improve the overall care of patients with cancer.…”

Section: Introductionmentioning

confidence: 99%

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Oral administration of nanomicelle curcumin in the prevention of radiotherapy‐induced mucositis in head and neck cancers

Delavarian

Pakfetrat

Ghazi

et al. 2019

Special Care in Dentistry

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Oral mucositis (OM) is a complication of head and neck cancer (HNC) therapy with negative impact on the quality of life. Although definitive treatment has not yet been established, there is interest towards the use of natural compounds owing to their few side effects. Curcumin has a variety of biological and pharmacological properties including anticancer and anti‐inflammatory effects. Aim The aim of this study is to evaluate the effect of curcumin in the form of nanomicelle on OM in HNC patients receiving radiotherapy. Methods In this clinical trial, 32 HNC patients were allocated to case and control groups, and respectively received nanocurcumin or placebo during radiotherapy. Results We found a statistically significant difference in the severity of mucositis between the 2 groups at all visits. In contrast to the control‐group patients, who all developed OM in the 2nd week of radiotherapy, only 32% of the case group developed OM with no obvious oral or systemic side effects. Conclusion Our data show that nanomicelle curcumin is an effective agent in the prevention of OM or reducing its severity. Thus, the administration of nanocurcumin can be considered as a reasonable approach to hinder the development of OM in HNC patients requiring radiotherapy.

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Section: Introductionmentioning

confidence: 99%

“…can negatively impact treatment planning and prognosis. 2,6,7 It is therefore critical that mucositis can be prevented or treated to improve the overall care of patients with cancer.…”

mentioning

confidence: 99%

Oral administration of nanomicelle curcumin in the prevention of radiotherapy‐induced mucositis in head and neck cancers

Delavarian

Pakfetrat

Ghazi

et al. 2019

Special Care in Dentistry

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“…Total GTV dose and single fraction dose have been well-recognized as risk factors to develop severe OM. A previous report indicated that a radiation dose of 30 Gy is a related factor of severe OM [18] . Doctor Vera-Lionch M [19] reported that risk increased when dose reached 50 Gy.…”

Section: Discussionmentioning

confidence: 98%

Correlated factors of acute oral mucosal and skin reaction induced by radiotherapy in hypopharyngeal carcinoma

Wang¹,

Lu²,

Huang³

et al. 2020

Preprint

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Background This present retrospective single center study was intended to investigate the factors associated with acute radiation oral mucositis or dermatitis during hypopharyngeal carcinoma radiotherapy.Methods From May 2012 to December 2018, previously untreated 93 patients with hypopharyngeal squamous cell carcinoma received radiotherapy in Affiliated Cancer Hospital of Zhengzhou University were enrolled. Radiation Therapy Oncology Group (RTOG) scoring criteria were used for assessing the severity of toxicities. Patients are therefore classified into “mild reaction group” (G0~G1) and “acute reaction group” (G2~G4). Single variate was applied to screen out factors with significant difference between mild and acute reaction groups, multivariate analysis was used to detect independent risk factors from those related. A total of 16 medical and laboratory indexes were included to examine, i.e., gender, age, smoking history, primary site, history of hypotension and diabetes, treatment modalities, dose, T (tumor) staging, N (reginal lymph node) staging, as well as hemoglobin value (1 week before radiotherapy). Relevant data used for the study were collected from clinical records.Results Total of 93 subjects completed radiotherapy. Acute mucositis occurred in 75 patients, and 27 cases developed acute radiation dermatitis. Smoking history, post-operative radiotherapy, concurrent chemotherapy, T staging, N staging, total dose (Gy) for GTV, single fraction dose (Gy) for GTV, and hemoglobin value (1 week before radiotherapy) showed significant differences between G0~G1 and G2~G4 groups of oral mucosa reaction; significant differences between mild and acute dermatitis reaction groups were found in diabetes history, hemoglobin value, age, total dose (Gy). Multivariate analysis showed that higher hemoglobin value ( OR = 1.120, P = 0.031), smoking history ( OR = 0.070, P = 0.031) were independent risk factor of acute OM; significant relationships for acute skin reaction were found with hemoglobin value ( OR = 1.059, P = 0.034) and older age ( OR = 1.068, P = 0.036).Conclusion Multivariate analysis showed higher hemoglobin value and smoking history to be the most relevant factors independently predicting grades 2 or higher OM; higher hemoglobin value and older age were found to be significantly associated with acute skin reaction.

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“…Mucositis was known to have a dose-effect relation with RT; however, the ability of clinical or dosimetric parameters in predicting severe mucositis was still controversial, using IMRT technique [17,18]. In the study of Li et al [19]., weight loss and V30Gy predict severe oral mucositis in NPC patients treated by concurrent chemo-IMRT. In contrast, the mean dose in the oral cavity was found to impact the duration of oral mucositis by Orlandi et al [20].…”

Section: Discussionmentioning

confidence: 99%

Gross tumor volume determines toxicity and quality of life for patients with nasopharyngeal carcinoma treated by concurrent chemoradiotherapy with simultaneously integrated boost technique

Huang

Chuang

Huang

et al. 2020

Preprint

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Background: To evaluate the impact of gross tumor volume (GTV) on toxicities and quality of life (QoL) for patients with nasopharyngeal carcinoma (NPC) treated by concurrent chemoradiotherapy with simultaneously integrated boost technique (chemo-SIB-IMRT). Methods: A total of 278 NPC patients with stage II-IVb treated by chemo-SIB-IMRT were enrolled. Toxicities were evaluated according to CTCAE version 4.03. QoL outcomes (n=219) were measured by using the EORTC QLQ-C30 and HN35 questionnaires at the time point of 12 months after chemo-SIB-IMRT. Results: A higher GTV was observed to be significantly associated with a higher mean or maximal dose in most organs at risk, together with more severe acute (mucositis, dermatitis, weight loss, and use of analgesic) and late toxicities (xerostomia, neck fibrosis, and radiation neuropathy). A linear regression model revealed that a higher GTV was significantly associated with a decline in role functioning and an increment in taste/smell, speech, social eating, opening mouth, dry mouth, and sticky saliva. Conclusion: GTV is the determining factor of some acute and late toxicities and QoL scales for NPC patients treated by chemo-SIB-IMRT.

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Impact of dose volume parameters and clinical factors on acute radiation oral mucositis for locally advanced nasopharyngeal carcinoma patients treated with concurrent intensity-modulated radiation therapy and chemoradiotherapy

Cited by 26 publications

References 30 publications

Oral administration of nanomicelle curcumin in the prevention of radiotherapy‐induced mucositis in head and neck cancers

Oral administration of nanomicelle curcumin in the prevention of radiotherapy‐induced mucositis in head and neck cancers

Correlated factors of acute oral mucosal and skin reaction induced by radiotherapy in hypopharyngeal carcinoma

Gross tumor volume determines toxicity and quality of life for patients with nasopharyngeal carcinoma treated by concurrent chemoradiotherapy with simultaneously integrated boost technique

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