Acute Radiation Mucositis Assessed Changes Over Time by Oral Mucosal Dose Surface Model in Head and Neck Cancers Treated by Carbon Ion Radiotherapy

Musha, Atsushi

Acute Radiation Mucositis Assessed Changes Over Time by Oral Mucosal Dose Surface Model in Head and Neck Cancers Treated by Carbon Ion Radiotherapy

Atsushi Musha , Gunma University Heavy Ion Medical Center, Maebashi, Japan

Masaru Ogawa , Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan

Takaya Makiguchi PhD, Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan

Hirofumi Shimada , Gunma University Heavy Ion Medical Center, Maebashi, Japan

Katsuyuki Shirai , Gunma University Heavy Ion Medical Center, Maebashi, Japan

Jun-ichi Saitoh , Gunma University Heavy Ion Medical Center, Maebashi, Japan

Satoshi Yokoo , Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan

Yoshiyuki Suzuki , Gunma University Heavy Ion Medical Center, Maebashi, Japan

Tatsuya Ohno , Gunma University Heavy Ion Medical Center, Maebashi, Japan

Takashi Nakano , Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan

Aim

Hypofractionated carbon ion radiotherapy has shown the usefulness for x-ray resistant head and neck tumors.^1,2) However, the relationship between carbon ion dose, change over time and severity of acute radiation mucositis (RM) has been unclear. In this study, RM and the dose dependency were assessed changes over time by oral mucosal dose surface model (OMDSM) developed by Gunma University.

Methods

Between 2011 and 2012, 18 patients were treated by carbon ion radiotherapy at Gunma University Heavy Ion Medical Center. All primary tumors located in nasal cavity. Patients with malignant melanoma were 12, adenoid cystic carcinoma were 4, basal cell adenocarcinoma was 1, and olfactory neuroblastoma was 1. Total dose to the tumor was determined according to the clinical protocol. There were all patients received 64.0 Gy(RBE) in 16 fractions. Radiation mucositis was graded by Radiation Therapy Oncology Group (RTOG) grading system. A maximum dose of palate and tongue was evaluated in each patient by using OMDSM based on the MIM software. We assessed a time change of the RM. In addition, location of the high dose area was compared to pictures of RM taken weekly during and after carbon ion radiotherapy.

Results

RTOG grade RM in palate has been gradually rising after about 6 times of irradiation. On the other hand, tongue was about 8 times. RM gradually decreased one week after 16 times of irradiation. The location of RM was well correlated with high radiation dose area by OMDSM. All RM were recovered until a few months after completion of carbon ion radiotherapy.

Conclusions

The significant relationship between maximum dose of OMDSM and severity of acute RM was gradually observed. Especially, Grade 2 to3 RM was well correlated with high radiation dose area of carbon ion beams.

References

1. Mizoe JE, et al. Radiother Oncol. 2012;103(1):32-37.

2. Ohno T. The EPMA Journal. 2013;4:9.