Li et al reported 2 models for predicting severe oral mucositis in a patient undergoing chemo-radiation for nasopharyngeal cancer. One model uses the radiation dose based on mucosal surface contour. The authors are from Zhejiang Cancer Hospital, Zhejiang Key Laboratory of Radiation Oncology, Quanzhou First Hospital Affiliated to Fujian Medical University, People's Hospital of Maoming, Shanghai Pulmonary Hospital and Hangzhyou YITU Healthcare Technology Co, Ltd.
Patient selection: Chinese adult with nasopharyngeal cancer undergoing chemoradiation
Parameters:
(1) body mass index classification prior to radiation therapy
(2) retropharyngeal lymph node irradiation
(3) mucosal surface contour (MSC) as volume percentage of structure receiving >= 55 Gy)
Parameter
Finding
Points
BMI classification
16.5 to 18.49 (1)
0.021
18.5 to 22.99 (2)
0.042
23 to 24.99 (3)
0.063
25 to 29.99 (4)
0.084
30 to 39.99 (5)
0.105
retropharyngeal LN
none (0)
0
unilateral (1)l
0.126
bilateral (2)
0.252
volume percent receiving >= 55 Gy
0.052 * (percent)
risk score =
= SUM(points for the 3 parameters) - 1.480
Interpretation:
• A score >= -1.011 is associated with severe oral mucositis (RTOG grade >= 3).
Performance:
• The area under the ROC curve is 0.74.
• The sensitivity is 0.79 and specificity 0.60.
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