Table 1.
Dose-response models for head and neck normal tissue toxicity endpoints scored by patient self-reporting using quality of life questionnaires. Relevance scores presented as total and (patient material, study design, radiation therapy, modeling approach).
| Endpoint definition | Patient material | Time point | Significant non-dosimetric risk factors | Model and parameters (95% CIs) | Reference |
|---|---|---|---|---|---|
| Dysphagia | |||||
| Moderate to severe liquid swallowing based on EORTC QLQ-H&N35* | 354 head and neck cancer patients treated with chemo-RT 1.5 – 2 Gy/fx |
6 months post RT | Radiation technique: (IMRT vs. 3DCRT) | Logistic regression: βSG larynx mean dose = 0.074 (0.030, 0.11) βRadiation technique = −1.21 (−2.12, −0.27) Constant = −5.98 AUC = 0.75 (0.68–0.83) |
Christianen et al. 201220 Relevance score: 215 (80, 35, 40, 60) |
|
|
|
||||
| Moderate to severe soft food swallowing based on EORTC QLQ-H&N35 | Age: (>65 vs. 18–65 y) Tumor site: (Oro/nasopharynx vs. Other) Radiation technique: (IMRT vs. 3DCRT) |
Logistic regression: βMiddle PCM mean dose = 0.061 (0.030, 0.095) βAge = 1.20 (0.41, 2.00) βTumor site = 1.12 (0.31, 1.93) βRadiation technique = −0.91 (−1.77, −0.073) Constant = −5.83 AUC = 0.79 (0.72–0.86) |
|||
|
|
|
||||
| Moderate to severe soft food swallowing based on EORTC QLQ-H&N35 | Age: (>65 vs. 18–65 y) | Logistic regression: βSuperior PCM mean dose = 0.049 (0.030, 0.068) βSG larynx = 0.048 (0.010, 0.086) βAge = 0.80 (0.020, 1.57) Constant = −6.89 AUC = 0.77 (0.70–0.84) |
|||
|
|
|
||||
| Moderate to severe choking when swallowing based on EORTC QLQH& N35 | - | Logistic regression: βEsophagus inlet muscle V60 = 0.020 (0.010, 0.030) βSG larynx mean dose = 0.066 (0, 0.31) Constant = −7.07 AUC = 0.77 (0.67–0.86) |
|||
|
| |||||
| Xerostomia | |||||
| Xerostomia based on EORTC QLQH& N35 criteria | 178 head and neck cancer patients treated with IMRT or chemo-IMRT 2 Gy/fx |
6 months post RT | Baseline xerostomia: (Yes vs. No) | Logistic regression: βContralat. parotid mean dose = 0.047 (0.020, 0.077) βBaseline xerostomia = 0.72 (0.0, 1.44) Constant = −1.44 AUC = 0.68, R2 = 0.13 |
Beetz et al. 201230 Relevance score: 240 (75, 55, 50, 60) |
|
|
|
||||
| Sticky saliva based on EORTC QLQH& N35 criteria | - | Logistic regression: βContralat. submand. mean dose = 0.075 (0.030, 0.12) βSublingual glands mean dose = −0.06 (−0.10, −0.02) βSoft palate mean dose = 0.026 (0.0, 0.049) Constant = −3.24 AUC = 0.70, R2 = 0.17 |
|||
AUC – Area under the receiver operating characteristics curve
R2 – Pseudo R2 values measuring goodness-of-fit
*
European Organisation for Research and Treatment of Cancer head and neck cancer module quality of life questionnaire 35