Scripties UMCG - Rijksuniversiteit Groningen
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A prospective cohort study on acute radiation-induced toxicity in the head andneck region : Development of normal tissue complication probability models.

(2016) Al-Saidi, A.M.A.

Background: The purpose of this study was to identify which dose-volume parameters and
other pre-treatment factors can be used to predict most prevalent acute radiation-induced
toxicities, including xerostomia, dysphagia, mucositis, sticky saliva and loss of taste during
and immediately after radiation in the head and neck region.
Materials and methods: At the department of Radiation Oncology of the UMCG, a
retrospective analysis in a prospective cohort study was performed including 210 patients
with head and neck squamous cell carcinoma (HNSCC) treated with curative
(chemo)radiation. In all patients, acute radiation-induced toxicity was scored prospectively.
Univariable and multivariable logistic regression analysis were performed to develop
predictive models for grade ≥2 xerostomia, grade ≥4 dysphagia, grade ≥3 mucositis and grade
≥2 sticky saliva, scored at a weekly basis according to the CTCAEv4.0 international toxicity
scoring system to determine which dose-volume parameters were the most important
prognostic factors for the development of acute side effects.
Results: The multivariable logistic regression analyses revealed different prognostic factors:
the mean dose to the oral cavity for xerostomia, the mean dose to the pharyngeal constrictor
muscle for dysphagia, the mean dose to the oral cavity for mucositis and the mean dose to the
contralateral submandibular gland for sticky saliva.
Conclusion: A number of significant associations were found between the dose distribution in
certain organs-at-risk (OARs) and acute toxicity in HNSCC. However, for introduction into
routine clinical practice, further research with more advanced statistical methods to improve
the reliability of the models followed by external validation in an independent patient cohort
is needed.

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