title: Prediction of Acute Radiation Mucositis using an Oral Mucosal Dose Surface Model in Carbon Ion Radiotherapy for Head and Neck Tumors.
abstract: OBJECTIVE
  To evaluate the dose-response relationship for development of acute radiation mucositis (ARM) using an oral mucosal dose surface model (OMDS-model) in carbon ion radiotherapy (C-ion RT) for head and neck tumors.
  
  
  METHODS
  Thirty-nine patients receiving C-ion RT for head and neck cancer were evaluated for ARM (once per week for 6 weeks) according to the Common Terminology Criteria for Adverse Events (CTCAE), version 4.0, and the Radiation Therapy Oncology Group (RTOG) scoring systems. The irradiation schedule typically used was 64 Gy [relative biological effectiveness (RBE)] in 16 fractions for 4 weeks. Maximum point doses in the palate and tongue were compared with ARM in each patient.
  
  
  RESULTS
  The location of the ARM coincided with the high-dose area in the OMDS-model. There was a clear dose-response relationship between maximum point dose and ARM grade assessed using the RTOG criteria but not the CTCAE. The threshold doses for grade 2-3 ARM in the palate and tongue were 43.0 Gy(RBE) and 54.3 Gy(RBE), respectively.
  
  
  CONCLUSIONS
  The OMDS-model was useful for predicting the location and severity of ARM. Maximum point doses in the model correlated well with grade 2-3 ARM.
authors.affiliation: Gunma University Heavy Ion Medical Center, Maebashi, Japan; Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Musha
authors.affiliation: Gunma University Heavy Ion Medical Center, Maebashi, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Shimada
authors.affiliation: Gunma University Heavy Ion Medical Center, Maebashi, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Shirai
authors.affiliation: Gunma University Heavy Ion Medical Center, Maebashi, Japan.
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Saitoh
authors.affiliation: Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yokoo
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chikamatsu
authors.affiliation: Gunma University Heavy Ion Medical Center, Maebashi, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ohno
authors.affiliation: Gunma University Heavy Ion Medical Center, Maebashi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000532:radiotherapy; D063193:Heavy Ion Radiotherapy / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009061:Mouth Mucosa / Q000473:pathology* / Q000528:radiation effects*; D052016:Mucositis / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D011832:Radiation Injuries / Q000175:diagnosis* / Q000453:epidemiology; D011879:Radiotherapy Dosage; D012720:Severity of Illness Index