title: Study of functional infrared imaging for early detection of mucositis in locally advanced head and neck cancer treated with chemoradiotherapy.
abstract: OBJECTIVE
  Chemoradiotherapy (CRT) has led to improved efficacy in treating locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN) but has led to almost universal in-field mucositis. Patients treated with the same regimen often have differences in mucositis occurrence and severity. Mucositis induced via radiation is known to represent an intense inflammatory response histologically. We hypothesized that patients destined to display severe mucocutaneous toxicity would demonstrate greater alterations in thermal intensity early in therapy than identically treated counterparts. This will allow identification of patients that will require more intensive supportive care using thermal imaging technology.
  
  
  METHODS
  Subjects with LA-SCCHN (oral cavity or oropharynx) being treated with the identical chemoradiotherapy regimen underwent baseline and weekly thermal imaging. Changes in skin temperature caused by mucositis and dermatitis compared with a reference area (ΔT were calculated and correlated to grade of mucositis based on NCI-CTCAE 3.0.
  
  
  RESULTS
  Thirty-four subjects were enrolled. Grade 3 mucositis and dermatitis was observed in 53% and 21%, respectively. We observed a statistically significant positive association between an early rise in ΔT and mucositis grade (p value=0.03).
  
  
  CONCLUSIONS
  Thermal imaging is able to detect small and early changes in skin surface temperature that may be associated with development of mucositis in patients being treated with chemoradiotherapy.
authors.affiliation: Department of Medicine, University of Chicago, United States; University of Chicago Comprehensive Cancer Center, United States. Electronic address: ecohen@medicine.bsd.uchicago.edu.
authors.forename: Ezra E W
authors.initials: EE
authors.lastname: Cohen
authors.forename: Omar
authors.initials: O
authors.lastname: Ahmed
authors.forename: Masha
authors.initials: M
authors.lastname: Kocherginsky
authors.forename: Galyna
authors.initials: G
authors.lastname: Shustakova
authors.forename: Emily
authors.initials: E
authors.lastname: Kistner-Griffin
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Salama
authors.forename: Volodymyr
authors.initials: V
authors.lastname: Yefremenko
authors.forename: Valentyn
authors.initials: V
authors.lastname: Novosad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects; D005260:Female; D006358:Hot Temperature; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000628:therapy*; D052016:Mucositis / Q000175:diagnosis* / Q000209:etiology; D009959:Oropharyngeal Neoplasms / Q000628:therapy*; D011855:Radiodermatitis / Q000175:diagnosis* / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult
keywords: Chemoradiation therapy; Head and neck cancer; Imaging; Mucositis