Predictive Risk Factors Associated with Severe Radiation-Induced Mucositis in Nasopharyngeal or Oropharyngeal Cancer Patients: A Retrospective Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Setting and Design
2.2. Ethical Statement
2.3. Outcome
2.4. Characteristics
2.5. Oral Management Associated with Radiotherapy
2.6. Statistical Analysis
3. Results
3.1. Patients
3.2. Association of Exploratory Variables with Grade 3 Mucositis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Radiotherapy-Induced Mucositis | ||||||
---|---|---|---|---|---|---|
Grade 1 and 2 | Grade 3 | |||||
N = 53 | N = 47 | |||||
Characteristic | Category | N | % | N | % | |
Primary tumor location | Nasopharynx | 10 | 19 | 12 | 26 | |
Oropharynx | 43 | 81 | 35 | 74 | ||
Histopathology | Nasopharynx | |||||
Squamous cell carcinoma | 10 | 100 | 8 | 67 | ||
Differentiation of squamous cell carcinoma | N | |||||
Keratinizing | 1 | |||||
Non-keratinizing | 11 | |||||
Basaloid | 3 | |||||
Unknown | 3 | |||||
Lymphoepithelioma | 0 | 0 | 4 | 33 | ||
Oropharynx | ||||||
Squamous cell carcinoma | 43 | 100 | 35 | 100 | ||
Differentiation of squamous cell carcinoma | N | |||||
Keratinizing | 18 | |||||
Non-keratinizing | 21 | |||||
Basaloid | 0 | |||||
Unknown | 39 | |||||
p 16 protein | N | |||||
Positive | 27 | |||||
Negative | 21 | |||||
Unknown | 30 | |||||
Sex | Male | 45 | 85 | 36 | 77 | |
Female | 8 | 15 | 11 | 23 | ||
Age | Median (25–75% tile) | 66.0 (62.0–74.0) | 63.0 (57.5–71.0) | |||
BMI (kg/m2) | Median (25–75% tile) | 21.3 (19.4–24.9) | 21.8 (19.4–24.8) | |||
ECOG PS | 0 | 25 | 47 | 28 | 60 | |
1 | 20 | 38 | 12 | 25 | ||
2 | 8 | 15 | 7 | 15 | ||
Diabetes mellitus | Without | 43 | 81 | 42 | 89 | |
With | 10 | 19 | 5 | 11 | ||
Stage | 1 | 7 | 13 | 6 | 13 | |
2 | 8 | 15 | 2 | 4 | ||
3 | 11 | 21 | 10 | 21 | ||
4 | 27 | 51 | 29 | 62 | ||
Treatment | Radiotherapy alone | 13 | 25 | 7 | 15 | |
Bioradiotherapy | 5 | 9 | 9 | 19 | ||
Chemoradiotherapy | 35 | 66 | 31 | 66 | ||
Total radiation dose | Median (25–75% tile) | 70.0 (70.0–70.0) | 70.0 (68.0–70.0) | |||
Radiotherapy method | IMRT | 39 | 74 | 37 | 79 | |
3D-CRT | 14 | 26 | 10 | 21 | ||
Completion of radiotherapy | Completion | 50 | 94 | 42 | 89 | |
Discontinuation | 3 | 6 | 4 | 9 | ||
Treatment pause | 0 | 0 | 1 | 2 | ||
Neutrophil count (×103/dL) | Median (25–75% tile) | 4.0 (2.7–5.0) | 4.0 (2.9–5.5) | |||
Lymphocyte count (×103/dL) | Median (25–76% tile) | 1.7 (1.3–2.2) | 1.4 (1.2–1.8) | |||
NLR | Median (25–75% tile) | 2.2 (1.4–3.2) | 2.6 (1.8–4.0) | |||
Serum albumin (g/dL) | Median (25–75% tile) | 3.7 (3.4–4.0) | 3.7 (3.5–4.1) | |||
Hemoglobin (mg/dL) | Median (25–75% tile) | 13.2 (11.9–14.2) | 12.9 (11.8–13.9) | |||
Serum creatinine (mg/dL) | Median (25–75% tile) | 0.85 (0.73–0.96) | 0.83 (0.69–0.92) |
Variable | Category (Reference) | OR | 95% CI | p-Value |
---|---|---|---|---|
Sex | Male (Female) | 0.58 | 0.21–1.60 | 0.294 |
Age | 0.97 | 0.94–1.01 | 0.126 | |
BMI (kg/m2) | 1.00 | 0.89–1.11 | 0.930 | |
ECOG PS | ≥2 (0 or 1) | 0.98 | 0.33–2.96 | 0.978 |
Diabetes mellitus | With (Without) | 0.51 | 0.16–1.62 | 0.256 |
Primary tumor location | Nasopharynx (Oropharynx) | 1.47 | 0.57–3.81 | 0.423 |
Stage | III, IV (I, II) | 1.92 | 0.73–5.06 | 0.185 |
Therapy | BRT or CRT (Radiotherapy alone) | 1.86 | 0.67–5.14 | 0.233 |
Radiotherapy method | IMRT (3D-CRT) | 1.33 | 0.53–3.36 | 0.549 |
Total radiation dose (Gy) | 1.00 | 0.89–1.12 | 0.960 | |
Neutrophil count (×103/dL) | 0.92 | 0.77–1.10 | 0.370 | |
Lymphocyte count (×103/dL) | 0.41 | 0.20–0.86 | 0.018 | |
NLR | 1.00 | 0.85–1.17 | 0.960 | |
Serum albumin | 0.88 | 0.37–2.08 | 0.774 | |
Hemoglobin | 0.98 | 0.79–1.21 | 0.835 | |
Serum creatinine | 0.28 | 0.04–2.08 | 0.215 |
Risk Factor | Category (Reference) | OR | 95.0% CI | p-Value |
---|---|---|---|---|
Lymphocyte count (×103/dL) | 0.40 | 0.19–0.86 | 0.018 | |
Age | 0.98 | 0.94–1.02 | 0.301 | |
Stage | III or IV (I or II) | 1.56 | 0.53–4.56 | 0.416 |
Therapy | BRT or CRT (Radiotherapy alone) | 1.16 | 0.33–4.11 | 0.820 |
Radiotherapy method | IMRT (3D-CRT) | 1.51 | 0.54–4.21 | 0.435 |
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Kawashita, Y.; Soutome, S.; Umeda, M.; Saito, T. Predictive Risk Factors Associated with Severe Radiation-Induced Mucositis in Nasopharyngeal or Oropharyngeal Cancer Patients: A Retrospective Study. Biomedicines 2022, 10, 2661. https://doi.org/10.3390/biomedicines10102661
Kawashita Y, Soutome S, Umeda M, Saito T. Predictive Risk Factors Associated with Severe Radiation-Induced Mucositis in Nasopharyngeal or Oropharyngeal Cancer Patients: A Retrospective Study. Biomedicines. 2022; 10(10):2661. https://doi.org/10.3390/biomedicines10102661
Chicago/Turabian StyleKawashita, Yumiko, Sakiko Soutome, Masahiro Umeda, and Toshiyuki Saito. 2022. "Predictive Risk Factors Associated with Severe Radiation-Induced Mucositis in Nasopharyngeal or Oropharyngeal Cancer Patients: A Retrospective Study" Biomedicines 10, no. 10: 2661. https://doi.org/10.3390/biomedicines10102661