Table 1.
Patient (n = 39) and tumor characteristics, in patients with head and neck tumors treated via carbon ion radiotherapy.
Fig 1.
Oral mucosal dose surface model and corresponding mucositis.
Representative dose distributions (coronal image, palate, and tongue surface) in a patient with malignant melanoma of the right nasal cavity are shown. The location of the acute radiation mucositis (ARM) approximated the high radiation dose area. ARM was classified as grade 2 according to version 4 of the Common Terminology Criteria for Adverse Events (CTCAE)* and as grade 3 (palate) and grade 0 (tongue) according to the Radiation Therapy Oncology Group (RTOG) criteria. RBE, relative biological effectiveness.
Table 2.
Locations and stages of acute radiation mucositis in patients with head and neck tumors treated via carbon ion radiotherapy.
Fig 2.
Relationship between the maximum point dose in the oral mucosal dose surface model and acute radiation mucositis (ARM) grade (Common Terminology Criteria for Adverse Events [CTCAE] classification).
Maximum doses in the palate (a) and tongue (b) for grade 0–1 and grade 2–3 ARM. Data are presented as mean ± standard deviation. RBE, relative biological effectiveness.
Fig 3.
Relationship between the maximum point dose in the oral mucosal dose surface model and acute radiation mucositis (ARM) grade (Radiation Therapy Oncology Group [RTOG] classification).
(a) Maximum doses in the palate for grade 0–1 and grade 2–3 ARM. (b) Receiver operating characteristics (ROC) curve for grade 2–3 ARM in the palate (sensitivity, 1.0; specificity, 1.0). (c) Maximum doses in the tongue for grade 0–1 and grade 2–3 ARM. (d) ROC curve for grade 2–3 ARM in the tongue (sensitivity, 0.9; specificity, 0.9). Data are presented as mean ± standard deviation. RBE, relative biological effectiveness.
Fig 4.
Comparison of a dose-volume histogram of the tongue with acute radiation mucositis (ARM) grade.
ARM was graded according to the Radiation Therapy Oncology Group (RTOG) criteria. Data are presented as mean ± standard error. *p < 0.05. RBE, relative biological effectiveness.
Fig 5.
Temporal pattern of acute radiation mucositis (ARM) of the palate or tongue.
We assessed the change in ARM over time. The times are indicated as fractions 1 to 16, and 1 or 2 weeks and 1 month post irradiation.