title: Dose-response analysis of acute oral mucositis and pharyngeal dysphagia in patients receiving induction chemotherapy followed by concomitant chemo-IMRT for head and neck cancer.
abstract: Dose-response curves (DRCs) and the quantitative parameters describing these curves were generated for grade 3 oral mucositis and dysphagia in 144 patients using individual patient DVHs. Curve fits to the oral mucositis clinical data yielded parameter values of mean dose in 2 Gy equivalent, MD(50) = 51 Gy (95% CI 40-61), slope of the curve, k = 1(95% CI 0.6-1.5). R(2) value for the goodness of fit was 0.80. Fits to the grade 3 dysphagia clinical data yielded parameter values of MD(50) = 44.5 Gy (95% CI 36-53), k = 2.6 (95% CI 0.8-4.5). R(2) value for the goodness of fit was 0.65. This is the first study to derive DRCs in patients receiving induction chemotherapy followed by chemo-radiation (IC-C-IMRT) for head and neck cancer. The dose-response model described in this study could be useful for comparing acute mucositis rates for different dose-fractionation schedules when using IMRT for head and neck cancer.
authors.affiliation: Royal Marsden Hospital, Sutton, Surrey, UK. sabhide@yahoo.com
authors.forename: Shreerang A
authors.initials: SA
authors.lastname: Bhide
authors.forename: Sarah
authors.initials: S
authors.lastname: Gulliford
authors.forename: Ulrike
authors.initials: U
authors.lastname: Schick
authors.forename: Aisha
authors.initials: A
authors.lastname: Miah
authors.forename: Shane
authors.initials: S
authors.lastname: Zaidi
authors.forename: Katie
authors.initials: K
authors.lastname: Newbold
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Nutting
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Harrington
mesh_terms: D000208:Acute Disease; D059248:Chemoradiotherapy / Q000009:adverse effects; D003680:Deglutition Disorders / Q000209:etiology*; D004307:Dose-Response Relationship, Radiation; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*; D013280:Stomatitis / Q000209:etiology*