Prospective Evaluation to Establish a Dose Response for Clinical Oral Mucositis in Patients Undergoing Head-and-Neck Conformal Radiotherapy

Journal Article · Sat Nov 01 04:00:00 EDT 2008 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.01.060· OSTI ID:21128206

Narayan, Samir ^[1]; Lehmann, Joerg ^[1]; Coleman, Matthew A ^[2]; Vaughan, Andrew; Yang, Claus Chunli ^[1]; Enepekides, Danny; Farwell, Gregory ^[3]; Purdy, James A; Laredo, Grace ^[1]; Nolan, Kerry A.S.; Pearson, Francesca S ^[2]; Vijayakumar, Srinivasan ^[1]

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1. Department of Radiation Oncology, University of California Davis Medical Center, Sacramento, CA (United States)
2. Lawrence Livermore National Laboratory, Livermore, CA (United States)
3. Department of Otolaryngology, University of California Davis Medical Center, Sacramento, CA (United States)

Purpose: We conducted a clinical study to correlate oral cavity dose with clinical mucositis, perform in vivo dosimetry, and determine the feasibility of obtaining buccal mucosal cell samples in patients undergoing head-and-neck radiation therapy. The main objective is to establish a quantitative dose response for clinical oral mucositis. Methods and Materials: Twelve patients undergoing radiation therapy for head-and-neck cancer were prospectively studied. Four points were chosen in separate quadrants of the oral cavity. Calculated dose distributions were generated by using AcQPlan and Eclipse treatment planning systems. MOSFET dosimeters were used to measure dose at each sampled point. Each patient underwent buccal sampling for future RNA analysis before and after the first radiation treatment at the four selected points. Clinical and functional mucositis were assessed weekly according to National Cancer Institute Common Toxicity Criteria, Version 3. Results: Maximum and average doses for sampled sites ranged from 7.4-62.3 and 3.0-54.3 Gy, respectively. A cumulative point dose of 39.1 Gy resulted in mucositis for 3 weeks or longer. Mild severity (Grade {<=} 1) and short duration ({<=}1 week) of mucositis were found at cumulative point doses less than 32 Gy. Polymerase chain reaction consistently was able to detect basal levels of two known radiation responsive genes. Conclusions: In our sample, cumulative doses to the oral cavity of less than 32 Gy were associated with minimal acute mucositis. A dose greater than 39 Gy was associated with longer duration of mucositis. Our technique for sampling buccal mucosa yielded sufficient cells for RNA analysis using polymerase chain reaction.

• OSTI ID: 21128206
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 72; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
DOSEMETERS
DOSIMETRY
EVALUATION
HEAD
IN VIVO
MOSFET
MUCOUS MEMBRANES
NECK
ORAL CAVITY
PATIENTS
POLYMERASE CHAIN REACTION
RADIATION DOSE DISTRIBUTIONS
RADIATION DOSES
RADIOTHERAPY
RNA
SAMPLING