Development of Normal Tissue Complication Probability Model for Trismus in Head and Neck Cancer Patients Treated With Radiotherapy: The Role of Dosimetric and Clinical Factors

Masahiro Morimoto*, Henk P. Bijl, Arjen van der Schaaf, Cheng-Jian Xu, Roel J. H. M. Steenbakkers, Olga Chouvalova, Yasuo Yoshioka, Teruki Teshima, Johannes A. Langendijk

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)

Abstract

BACKGROUND/AIM: The aim of this study was to develop a normal tissue complication probability (NTCP) model for trismus in head and neck cancer (HNC) patients treated with radiotherapy (RT).

PATIENTS AND METHODS: Prospective measurements of maximum inter-incisal opening (MIO) were performed at baseline and 6 months after definitive RT in 132 HNC patients. The primary endpoint of this study was defined when a patient fulfilled both of the following criteria: 1) MIO at 6 months after RT ≤35 mm and 2) MIO at 6 months after RT ≤80% of baseline MIO. Eleven clinical factors and a wide range of dosimetric factors (mean dose, maximum dose, V5, V10, V20, and V40) in twelve organs at risk (OARs) were chosen as candidate prognostic variables.

RESULTS: Thirty out of 132 patients (23%) developed the primary endpoint. Multivariate logistic regression analysis revealed that the mean dose to the contralateral mandible joint (p=0.001) and baseline MIO (p=0.027) were independent prognostic factors.

CONCLUSION: A multivariable NTCP model for trismus in HNC patients treated with RT was established including the mean dose to contralateral mandible joint and baseline MIO.

Original languageEnglish
Pages (from-to)6787-6798
Number of pages12
JournalAnticancer Research
Volume39
Issue number12
DOIs
Publication statusPublished - Dec-2019

Keywords

  • Head and neck cancer
  • radiotherapy
  • trismus
  • normal tissue complication probability model
  • prediction
  • RADIATION-INDUCED TRISMUS
  • QUALITY-OF-LIFE
  • NASOPHARYNGEAL CARCINOMA
  • EXERCISE THERAPY
  • PENTOXIFYLLINE
  • PREVENTION
  • ONCOLOGY
  • FIBROSIS
  • IMPACT

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