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The kinetics of γ-H2AX during radiotherapy of head and neck cancer potentially allow for prediction of severe mucositis Cover

The kinetics of γ-H2AX during radiotherapy of head and neck cancer potentially allow for prediction of severe mucositis

Open Access
|Feb 2020

Figures & Tables

Figure 1

Level of γ-H2AX in peripheral blood lymphocytes before radiotherapy (A); in week 7 (B); week 2 (C) of treatment. Mild = grade 1 or 2 mucositis; Severe = grade 3. No grade 4 mucositis was observed.
Level of γ-H2AX in peripheral blood lymphocytes before radiotherapy (A); in week 7 (B); week 2 (C) of treatment. Mild = grade 1 or 2 mucositis; Severe = grade 3. No grade 4 mucositis was observed.

Figure 2

Kinetic of γ-H2AX level in peripheral blood lymphocytes (A). Level of Peripheral Blood Lymphocytes during treatment (B). Mild = grade 1 or 2 mucositis; severe = grade 3. No grade 4 mucositis was observed.
Kinetic of γ-H2AX level in peripheral blood lymphocytes (A). Level of Peripheral Blood Lymphocytes during treatment (B). Mild = grade 1 or 2 mucositis; severe = grade 3. No grade 4 mucositis was observed.

Demographics, staging and treatment information of studied patients

CharacteristicsTotalM 0-2M 3p-value
N = 50 (%)N = 35 (%)N = 15 (%)
SexMale44 (88)30 (85.7)14 (93.3)0.44
Female6 (12)5 (14.2)1 (6.6)
Parotid5 (10)5 (14.3)0 (0)
Oral cavity11 (22)7 (20)4 (26.7)
Larynx14 (28)10 (28.6)4 (26.7)
Primary siteHypopharynx4 (8)4 (11.4)0 (0)0.27
Oropharynx12 (24)6 (17.1)6 (40)
CUP2 (4)1 (2.8)1 (6.7)
Nasalcavity/paranasal sinuses2 (4)2 (5.7)0 (0)
T14 (8)2 (5.7)2 (13.3)
T217 (34)11 (31.4)6 (40)
T classificationT38 (16)7 (20)1 (6.7)0.49
T419 (38)14 (40)5 (33.3)
Tx2 (4)1 (2.8)1 (6.7)
N026 (52)19 (54.3)7 (46.7)
N classificationN14 (8)4 (11.4)0 (0)0.25
N220 (40)12 (34.3)8 (53.3)
SurgeryYes28 (56)22 (62.85)6 (40)0.13
No22 (44)13 (37.1)9 (60)
ConcomitantYes33 (66)26 (74.3)7 (46.7)0.06
chemotherapyNo17 (34)9 (25.7)8 (53.3)
ComorbiditiesYes34 (68)21 (60)13 (86.7)0.06
No16 (32)14 (40)2 (13.3)
Diabetes type II6 (12)5 (14.3)1 (6.7)
Selected comorbiditiesHypertension17 (34)12 (34.3)5 (33.3)0.09
Ischemic heart disease11 (22)4 (11.1)7 (46.7)

Level of γ-H2AX in peripheral blood lymphocytes before and during treatment

Week of radiotherapyMild mucositisSevere mucositisNo. of samplesp-value
MeanSDMeanSD
Before10.6416.3811.4011.71480.868
Week 18.488.9911.2410.78480.347
Week 27.229.8613.2711.94480.065
Week 39.4511.4612.4412.16480.403
Week 410.8114.1011.8715.46480.812
Week 514.9519.8811.9719.60470.624
Week 618.2520.968.9015.62470.121
Week 720.5023.133.814.78390.011*
Week 813.2310.825.468.8380.268

Grading of radiation-induced oral mucositis according to CTCAE v4 and EORTC/RTOG scales_6,7

Mucositis (oral)Grade 1Grade 2Grade 3Grade 4Grade 5
CTCAE v4Asymptomatic/mild symptoms, intervention not indicatedModerate pain not interfering with oral intake, modified diet indicatedSevere pain interfering with oral intakeLife-threating consequences, urgent intervention indicatedDeath
EORTC/ RTOGIrritation, may experience slight pain, not requiring analgesicPatchy mucositis that may produce inflammatory serosanquinitis discharge, may experience moderate pain requiring analgesiaConfluent, fibrinous mucositis, may include severe pain requiring narcoticUlceration, haemorrhage or necrosisN/A
DOI: https://doi.org/10.2478/raon-2020-0005 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Page range: 96 - 102
Submitted on: Dec 12, 2019
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Accepted on: Jan 16, 2020
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Published on: Feb 14, 2020
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2020 Joanna Kazmierska, Wojciech Barczak, Tomasz Winiecki, Łukasz Łuczewski, Magdalena Marciniak, Wiktoria Suchorska, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.