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Radiother Oncol. 2017 Feb;122(2):212-216. doi: 10.1016/j.radonc.2016.08.013. Epub 2016 Sep 20.

Radiotherapy induced dermatitis is a strong predictor for late fibrosis in head and neck cancer. The development of a predictive model for late fibrosis.

Author information

1
University Hospitals Leuven, Belgium. Electronic address: daan.nevens@uzleuven.be.
2
University Hospitals Leuven, Belgium.

Abstract

PURPOSE:

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.

MATERIAL/METHODS:

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 RTOG2-4 6months after the end of treatment.

RESULTS:

Radiodermatitis at the end of R(C)T ⩾grade 3 proved to be associated with the incidence of fibrosis RTOG2-4 at 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 RTOG2-4 at 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.

CONCLUSION:

A model for the prediction of fibrosis RTOG2-4 following 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 RTOG2-4 fibrosis at 6months.

KEYWORDS:

Fibrosis; Head and neck cancer; Radiodermatitis; Radiotherapy

PMID:
27663951
DOI:
10.1016/j.radonc.2016.08.013
[Indexed for MEDLINE]

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