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. 2021 Apr;4(2):e1317.
doi: 10.1002/cnr2.1317. Epub 2020 Dec 9.

The association between cumulative radiation dose and the incidence of severe oral mucositis in head and neck cancers during radiotherapy

Tomiko Sunaga  1   2 , Akiko Nagatani  1   2 , Naokazu Fujii  3 , Touji Hashimoto  4 , Toru Watanabe  1   2 , Tadanori Sasaki  1
Affiliations

The association between cumulative radiation dose and the incidence of severe oral mucositis in head and neck cancers during radiotherapy

Tomiko Sunaga et al. Cancer Rep (Hoboken). 2021 Apr.

Abstract

Background: Quality of life can be influenced by oral mucositis (OM), and it is necessary to implement OM management strategies before the initiation of radiotherapy (RT) in patients with head and neck cancer (HNC).

Aims: To examine the association between the cumulative radiation dose and the incidence of severe OM in HNC patients receiving RT.

Methods and results: A retrospective observational cohort study was conducted in a Showa University Fujigaoka Hospital, in Japan. We retrospectively analyzed 94 patients with HNC who developed OM during RT. We defined OM as a more than grade 2 OM. The cumulative incidence of OM curves of the two categories was estimated using the Kaplan-Meier method and compared using the log-rank test. We estimated the hazard ratio (HR) for OM after the adjustment of factors for covariates using Cox's regression analysis. Patients with smoking history had a significantly later development of OM than those with no smoking history (20 Gy-incidence OM 68.7% vs 39.7%, P = .003). In contrast, patients undergoing concurrent chemotherapy had an earlier development of OM than those undergoing RT alone (20 Gy-incidence OM 24.2% vs 55.7%, P < .001). Multivariate analysis revealed that no smoking history and concurrent chemotherapy were independent predictive factors, with a HR of 0.526 (P = .025) and 2.690 (P < .001), respectively.

Conclusion: We demonstrated that no smoking history and concurrent chemotherapy may be predictive of OM in HNC patients.

Keywords: concurrent chemotherapy; cumulative radiation dose; head and neck cancer; oral mucositis; predictive factors; radiotherapy.

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Conflict of interest statement

The authors have no conflicts of interest to report.

Figures

FIGURE 1
FIGURE 1
Kaplan‐Meier the incidence of oral mucositis curves according to the grade of oral mucositis, smoking history, and chemotherapy
See this image and copyright information in PMC

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References

    1. Bary F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA J Clin. 2018;68:394‐424. 10.3322/caac.21492. - DOI - PubMed
    1. Kam D, Salib A, Gorgy G, et al. Incidence of suicide in patients with head and neck cancer. JAMA Otolaryngol Head Neck Surg. 2015;141:1075‐1081. 10.1001/jamaoto.2015.2480. - DOI - PubMed
    1. Al‐Sarraf M, LeBlanc M, Giri PG, et al. Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized intergroup study 0099. J Clin Oncol. 1998;16:1310‐1317. 10.1200/JCO.1998.16.4.1310. - DOI - PubMed
    1. Trotti A, Bellm LA, Epstein JB, et al. Mucositis incidence, severity, and associated outcomes in patients with head and neck cancer receiving radiotherapy with or without chemotherapy: a systematic literature review. Radiother Oncol. 2003;66:253‐262. 10.1016/s0167-8140(02)00404-8. - DOI - PubMed
    1. Hata H, Ota Y, Ueno T, et al. Oral mucositis frequency in head and neck chemoradiotherapy. Toukeibugan. 2007;33:48‐53.

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