A treatment planning method for better management of radiation-induced oral mucositis in locally advanced head and neck cancer

Oral Mucositis (OM) is a common adverse effect of head and neck squamous cell carcinoma (HNSCC) treatment. The purpose of this study was to investigate the significance of early changes in tissue electrical parameters (TEPs) in predicting the development of OM in HNSCC patients receiving radiation therapy (RT). The current study combined two study designs. The first was a case-control study. The control group comprised of RT patients who did not receive head and neck RT, and patients with HNSCC who received RT comprised the case group. In the second part of the study, the case group was included in a parallel cohort. A total of 320 patients were assessed for eligibility, and 135 patients were enrolled. Double blinding was performed, and neither the patients nor the care providers knew the measured parameters. The primary outcome was the detection of between-group changes in local TEPs over the follow-up period. The secondary outcome was the appearance of OM grades II, III, or IV and the predictive value of local TEPs in determining the incidence of OM after RT. The variables, impedance module, resistance, reactance, phase angle, and capacitance, were analyzed by the receiver operator curves (ROC). The case and control groups did not differ in demographic and clinical characteristics. Radiation therapy increased the local impedance module, resistance, reactance, and phase angle and reduced the local tissue capacitance in both groups. Evaluation of TEPs in the first week of RT correlated with the development of OM lesions during cancer therapy. ROC analysis showed that local impedance module and resistance presented higher specificity than did other parameters in predicting OM. In conclusion, local tissue electrical parameters measured at the first RT week can be useful tools to predict oral mucositis.

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Association between the nutritional status and radiation pharyngeal mucositis in patients with head and neck cancer during radiotherapy: A longitudinal study

Zhang,

Wang,

Zhuang

et al. 2023

J Nutr Oncol

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Objective Radiation mucositis, especially pharyngeal mucositis, severely affects the oral intake of patients of head and neck cancer (HNC) during radiotherapy. Whether the nutritional status affects the severity of pharyngeal mucositis is currently unknown. This study investigated the incidence of malnutrition and radiation pharyngeal mucositis in patients with HNC during radiotherapy and analyzed the impact of the nutritional status on radiation pharyngeal mucositis. Methods Consecutive patients with HNC receiving radiotherapy were recruited for this longitudinal observational study. Data were collected at baseline (T1), midtreatment (T2), and at the end of treatment (T3). The Common Terminology Criteria for Adverse Events version 4.0 and the Global Leadership Initiative on Malnutrition criteria were used to assess pharyngeal mucositis and the nutritional status, respectively. Results There were 348 HNC patients who completed all assessments. The pharyngeal mucositis of patients with HNC was aggravated during radiotherapy (χ 2 = 553.521, P < 0.001). At T3, 56.0% of patients had moderate or severe pharyngeal mucositis. The proportion of patients with malnutrition increased significantly during treatment (21.3% at T1 vs 46.8% at T2 vs 76.1% at T3, χ 2 = 209.768, P < 0.001). Both a multivariable analysis of generalized estimating equations and a logistic regression analysis showed that pharyngeal mucositis was associated with malnutrition. Conclusions Malnutrition was common in patients with HNC during radiotherapy, and it was closely related to pharyngeal mucositis. Joint interventions targeting nutrition and symptom management should be considered for patients with HNC.

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A treatment planning method for better management of radiation-induced oral mucositis in locally advanced head and neck cancer

Cited by 8 publications

References 34 publications

Efficacy of the plantago major L. syrup on radiation induced oral mucositis in head and neck cancer patients: A randomized, double blind, placebo-controlled clinical trial

Efficacy of the plantago major L. syrup on radiation induced oral mucositis in head and neck cancer patients: A randomized, double blind, placebo-controlled clinical trial

Local tissue electrical parameters predict oral mucositis in HNSCC patients: A diagnostic accuracy double-blind, randomized controlled trial

Association between the nutritional status and radiation pharyngeal mucositis in patients with head and neck cancer during radiotherapy: A longitudinal study

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