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. 2019 Jan 21;14(1):14.
doi: 10.1186/s13014-019-1215-2.

A scoring system predicting acute radiation dermatitis in patients with head and neck cancer treated with intensity-modulated radiotherapy

Mitsue Kawamura  1 , Michio Yoshimura  2 , Hiromi Asada  3 , Mitsuhiro Nakamura  1   4 , Yukinori Matsuo  1 , Takashi Mizowaki  1
Affiliations

A scoring system predicting acute radiation dermatitis in patients with head and neck cancer treated with intensity-modulated radiotherapy

Mitsue Kawamura et al. Radiat Oncol. .

Abstract

Background and purpose: We created a scoring system incorporating dosimetric and clinical factors to assess the risk of severe, acute skin reactions in patients undergoing intensity-modulated radiation therapy (IMRT) to treat head and neck cancer (HNC).

Materials and methods: A total of 101 consecutive patients who received definitive IMRT or volumetric modulated arc therapy (VMAT) with a prescription dose of 70 Gy to treat HNC between 2013 and 2017 in our hospital were enrolled. Skin V5Gy, V10Gy, V20Gy, V30Gy, V40Gy, V50Gy, and V60Gy values delivered 5 mm within the body contour were compared between patients with Grades 1-2 and Grade 3 dermatitis. A scoring system was created based on logistic regression analysis (LRA) that identified the most significant dosimetric and clinical factors.

Results: The V60Gy was significantly associated with radiation dermatitis grade in both LRA and recursive partitioning analysis (RPA). A scoring system incorporating the V60Gy, concurrent chemotherapy status, age, and body mass index was used to divide all patients into three subgroups (0-1, 2-3, and 4-6 points) in the RPA. The incidence of Grade 3 dermatitis significantly differed among the subgroups (0, 20.5, and 58.6%, respectively, P < 0.01).

Conclusions: A risk analysis model incorporating dose-volume parameters successfully predicted acute skin reactions and will aid in the appropriate management of radiation dermatitis.

Keywords: Head-and- neck cancer; IMRT; Skin dose; VMAT.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by our local ethics committee, Kyoto University Graduate School and Faculty of Medicine, Kyoto University Hospital Ethics committee; reference number E1810.

Consent for publication

All authors approved the final version of the manuscript.

Competing interests

We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
a DVHs of patients with different dermatitis grades. b Bar graph of each dermatitis grade
Fig. 2
Fig. 2
RPA by risk classification score
Fig. 3
Fig. 3
Representative images of patients with dermatitis of various grades. Skin that received 20 Gy (V20Gy): yellow; V60Gy: orange
See this image and copyright information in PMC

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