Tongue surface model can predict radiation tongue mucositis due to intensity-modulated radiation therapy for head and neck cancer

Musha, Atsushi; Fukata, Kyohei; Saitoh, Jun; Shirai, Katsuyuki; Abe, Takanori; Mizukami, Tatsuji; Kawashima, Motohiro; Yokoo, Satoshi; Chikamatsu, Kazuaki; Ohno, Tatsuya; Nakano, Takashi

doi:10.1016/j.ijom.2019.06.012

Cited by 9 publications

(5 citation statements)

References 14 publications

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“…Oral mucositis is a common side effect of chemotherapy and radiotherapy. The incidence is about 85–100% in HNC patients receiving radiotherapy [ 5 ]. Previous studies have shown that the severity of oral mucositis is affected by radiotherapy mode, low body mass, prolonged neutrophil recovery, and young age [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

The relationship of serum gastrin-17 and oral mucositis in head and neck carcinoma patients receiving radiotherapy

Liu

Shi

et al. 2022

Discov Onc

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Objective The aim of this study was to analyze the relationship of serum gastrin-17 (G-17) and oral mucositis in head and neck carcinoma (HNC) patients receiving radiotherapy. Methods Serum G-17 were detected in patients before and after radiotherapy. Patients were divided into high G-17 group (baseline serum G-17 ≥ 5pmol/L) and low G-17 group (baseline serum G-17 < 5pmol/L). The severity of oral mucositis was analyzed between the two groups. Other complications such as dysphagia, salivary gland, mandible, thyroid function, larynx, pain, and weight loss were also investigated. Results Forty-two patients were analyzed in this study. The level of serum G-17 had a significant decrease after radiotherapy (7.29 ± 5.70pmol/L versus 4.93 ± 4.46pmol/L, P = 0.038). In low serum G-17 group, the incidences of grade 0, 1–2 and 3–4 of oral mucositis were 0%, 30.4%, and 69.6%, respectively. In high serum G-17 group, the incidences of grade 0, 1–2 and 3–4 of oral mucositis were 0%, 63.2%, and 36.8%, respectively. Pearson correlation analysis showed that serum G-17 was negatively correlated with oral mucositis (r=-0.595, P < 0.01). Weight loss of low G-17 group was more serious than that of high G-17 group. Conclusion Serum G-17 has a close relationship with oral mucositis. Baseline serum G-17 may be a potential predictor for the severity of oral mucositis in HNC patients receiving radiotherapy.

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Section: Introductionmentioning

confidence: 99%

The relationship of serum gastrin-17 and oral mucositis in head and neck carcinoma patients receiving radiotherapy

Liu

Shi

et al. 2022

Discov Onc

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“…Radiation-induced oral mucositis was related to a cumulative radiation dose to the OC between 15 Gy (V15Gy) and 39 Gy (V39Gy) [32,33]. In patients using an S MP, the V15Gy(RBE) and V30Gy(RBE) of the COM were higher than those using the SC TDD (14.7 vs. 6.4%, and 2.0 vs. 0.5%, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…The development of radiation-induced tongue mucositis is associated with tongue volumes that receive low-and high-dose radiation. Musha et al reported that patients receiving 16.0-73.0 Gy to the tongue were susceptible to grade 2-3 acute radiation tongue toxicity [32]. Therefore, a decrease in the tongue volume that receives low-dose radiation may be effective in preventing tongue mucositis.…”

Section: Discussionmentioning

confidence: 99%

Tongue Displacement Device in Decreasing the Radiation Dose to Tongue and Preventing Proton Beam Overshoot in Proton Therapy for Unilateral Head and Neck Cancer

Hong

et al. 2021

Front. Phys.

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The aim of this study was to evaluate the dosimetric characteristics of a semi-customized tongue displacement device (SCTDD) fabricated using a 3D printer for patients receiving unilateral head and neck irradiation with intensity-modulated proton therapy (IMPT) and assess its feasibility as a proton beam stopper compared to a standard mouthpiece (SMP). Seven consecutive patients, three with tonsil cancer, and four with oral cavity cancer were included in this retrospective study. Planning computed tomography (CT) images of each patient were acquired for each device. Both the SCTDD and SMP plans were generated using a single-field optimized IMPT. The clinically relevant dose-volume parameters for the organs at risk (OARs), especially the tongue, were compared between the SCTDD and SMP plans. Additionally, to assess the feasibility of SCTDD as a proton beam stopper, the dose to the contralateral oral mucosa (COM) was compared with that from sMP use. The use of scTDD resulted in a statistically significant decrease in the radiation dose to the tongue and COM compared to sMP. The median mean dose to the tongue was significantly reduced with SCTDD (18.3 Gy(RBE)) compared to the SMP (22.9 Gy(RBE)) (p = 0.016). The percentages of tongue volume receiving doses between 15 and 60 Gy(RBE) were significantly lower with SCTDD. In the COM, SCTDD resulted in a significantly lower median mean (2.9 Gy(RBE) vs. 7.9 Gy(RBE), p = 0.018) and maximum dose (39.1 Gy(RBE) vs. 41.6 Gy(RBE), p = 0.018) doses compared to SMP. The SCTDD effectively decreased the radiation dose to the tongue compared to SMP in patients undergoing unilateral head and neck irradiation with IMPT and acted as a proton beam stopper to protect normal tissues located behind the target volume, such as the COM.

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“…This is consistent with the characteristics of a wide range of low dose in tomography helical radiotherapy. Musha et al reported that not only the high-dose anatomical region, but also the extensive low-dose region was associated with the development of mucositis (28). Hence, reduction of the low-dose volume is as important as high-dose volume in preventing oral mucositis.…”

Section: Discussionmentioning

confidence: 99%

Predictive Model and Precaution for Oral Mucositis During Chemo-Radiotherapy in Nasopharyngeal Carcinoma Patients

Jin

et al. 2020

Front. Oncol.

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Purpose: To explore risk factors for severe acute oral mucositis of nasopharyngeal carcinoma (NPC) patients receiving chemo-radiotherapy, build predictive models and determine preventive measures. Methods and Materials: Two hundred and seventy NPC patients receiving radical chemo-radiotherapy were included. Oral mucosa structure was contoured by oral cavity contour (OCC) and mucosa surface contour (MSC) methods. Oral mucositis during treatment was prospectively evaluated and divided into severe mucositis group (grade ≥ 3) and non-severe mucositis group (grade < 3) according to RTOG Acute Reaction Scoring System. Nineteen clinical features and nineteen dosimetric parameters were included in analysis, least absolute shrinkage and selection operator (LASSO) logistic regression model was used to construct a risk score (RS) system. Results: Two predictive models were built based on the two delineation methods. MSC based model is more simplified one, it includes body mass index (BMI) classification before radiation, retropharyngeal lymph node (RLN) area irradiation status and MSC V55%, RS = −1.480 + (0.021 × BMI classification before RT) + (0.126 × RLN irradiation) + (0.052 × MSC V55%). The cutoff of MSC based RS is −1.011, with an area under curve (AUC) of 0.737 (95%CI: 0.672-0.801), a specificity of 0.595 and a sensitivity of 0.786. OCC based model involved more variables, RS= −4.805+ (0.152 × BMI classification before RT) + (0.080 × RT Technique) + (0.097 × Concurrent Nimotuzumab) + (0.163 × RLN irradiation) + (0.028 × OCC V15%) + (0.120 × OCC V60%). The cutoff of OCC based RS is −0.950, with an AUC of 0.767 (95%CI: 0.702-0.831), a specificity of 0.602 and a sensitivity of 0.819. Analysis in testing set shown higher AUC of MSC based model than that of OCC based model (AUC: 0.782 vs 0.553). Analysis in entire set shown AUC in these two method-based models were close (AUC: 0.744 vs 0.717).

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Tongue surface model can predict radiation tongue mucositis due to intensity-modulated radiation therapy for head and neck cancer

Cited by 9 publications

References 14 publications

The relationship of serum gastrin-17 and oral mucositis in head and neck carcinoma patients receiving radiotherapy

The relationship of serum gastrin-17 and oral mucositis in head and neck carcinoma patients receiving radiotherapy

Tongue Displacement Device in Decreasing the Radiation Dose to Tongue and Preventing Proton Beam Overshoot in Proton Therapy for Unilateral Head and Neck Cancer

Predictive Model and Precaution for Oral Mucositis During Chemo-Radiotherapy in Nasopharyngeal Carcinoma Patients

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