Predictors of mucositis in oropharyngeal and oral cavity cancer in patients treated with volumetric modulated radiation treatment: A dose-volume analysis

Background. The purpose of this study was to assess predictors of mucositis in oropharyngeal and oral cavity cancer after definitive or adjuvant volumetric modulated arc radiotherapy (VMAT) +/- chemotherapy. Methods. Fifty patients were evaluated. Statistical analysis was performed for the following parameters as potential predictors of mucositis >= G2: total oral mucosa and oral mucosa minus target high-low radiation dose regions (planning target volumes [PTVs]), mean dose (D-mean), maximum dose (D-max), chemotherapy, weight loss, and dysphagia. Results. Mucositis >= G2 was found to be statistically related to chemotherapy, weight loss, dysphagia >= G2, total oral mucosa D-mean >= 50 Gy and D-max >= 65 Gy, V-45 (Gy) >40%, V-50 Gy >30%, and V-55 Gy >20% of the oral mucosa minus target PTVs. A ratio between total oral mucosa and oral mucosa minus target PTVs >2.5 is related to G3 mucositis (p = .03). Conclusion. New parameters were found as predictors of moderate-severe mucositis. (C) 2015 Wiley Periodicals, Inc.