Radiotherapy induced dermatitis is a strong predictor for late fibrosis in head and neck cancer. The development of a predictive model for late fibrosis.
To determine if the severity of radiodermatitis at the end of radio(chemo)therapy (R(C)T) for head and neck cancer (HNC) is a predictive factor for late fibrosis of the neck and to find a model to predict neck fibrosis grade⩾2 (fibrosis RTOG2-4) at 6months following R(C)T for HNC.



161 patients were prospectively included. We correlated radiodermatitis at the end of RCT, age, sex, T/N stage, tumor site, concomitant chemotherapy, upfront neck dissection, neo-adjuvant chemotherapy, accelerated RT, smoking, alcohol consumption, HPV status and the dose prescribed to the elective neck with fibrosis RTOG2-46months after the end of treatment.



Radiodermatitis at the end of R(C)T ⩾grade 3 proved to be associated with the incidence of fibrosis RTOG2-4at 6months (p<0.01). Furthermore, upfront neck dissection (p<0.01), increasing N stage (p<0.01) and tumor site (p=0.02) are significantly associated in univariate analysis with fibrosis RTOG2-4at 6months of follow-up. Upfront neck dissection and radiodermatitis grade⩾3 at the end of R(C)T were identified by our multivariate model. Additionally, increasing N stage was selected as an independent predictor variable. The AUC for this model was 0.92.



A model for the prediction of fibrosis RTOG2-4following R(C)T for head and neck cancer is presented with an AUC of 0.92. Interestingly, radiodermatitis grade⩾3 at the end of R(C)T is associated with RTOG2-4fibrosis at 6months.
University Hospitals Leuven, Belgium. Electronic address: daan.nevens@uzleuven.be.
Daan
D
Nevens
University Hospitals Leuven, Belgium.
Fréderic
F
Duprez
University Hospitals Leuven, Belgium.
Jean Francois
JF
Daisne
University Hospitals Leuven, Belgium.
Annouschka
A
Laenen
University Hospitals Leuven, Belgium.
Wilfried
W
De Neve
University Hospitals Leuven, Belgium.
Sandra
S
Nuyts
D000328:Adult; D000368:Aged; D019540:Area Under Curve; D005260:Female; D005355:Fibrosis; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000473:pathology; D037981:Neck Dissection; D009367:Neoplasm Staging; D011336:Probability; D011855:Radiodermatitis / Q000209:etiology*
Fibrosis; Head and neck cancer; Radiodermatitis; Radiotherapy