Impact of dose volume parameters and clinical factors on acute radiation oral mucositis for locally advanced nasopharyngeal carcinoma patients treated with concurrent intensity-modulated radiation therapy and chemoradiotherapy

Abstract Purpose To prospectively identify the predictive value of different dosimetric parameters and also assess the predictors of acute radiation oral mucositis (ROM). Methods In accordance with the RTOG scoring criteria, ninety-two patients with locally advanced nasopharyngeal carcinoma (NPC) treated with concurrent chemoradiotherapy were evaluated for acute ROM which was defined as severe when the score ≥3. Patients’ medical records and dosimetric data exported from IMRT plan enable the authors to perform a statistical analysis for the parameters as potential predictors of severe ROM. Results Body weight loss and V30 Gy ( p  = 0.017 and 0.003, respectively) are related factors to severe ROM. As the receiver operating characteristics (ROC) curve shows, the threshold value of V30 for severe ROM was 73.155% (sensitivity, 0.842; specificity, 0.671), and the area under V30 Gy curves was 0.753 ( p  = 0.001). Conclusion New parameters were found as predictors of severe ROM using dosimetric analysis.