A prospective cohort study on acute radiation-induced toxicity in the head and neck region : Development of normal tissue complication probability models.

Al-Saidi, A.M.A. (2016) A prospective cohort study on acute radiation-induced toxicity in the head and neck region : Development of normal tissue complication probability models. thesis, Medicine.

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Abstract

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.

Item Type:	Thesis (Thesis)
Supervisor name:	Locatie: Radiotherapie UMCG and Facultaire begeleider: and Langendijk, Prof. Dr. J.A.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:00
Last Modified:	25 Jun 2020 11:00
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2014

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