Neh H, de Vette S P M, Stoffers R H, Zhou G, van Ooijen P M A, Sijtsema N M, Brouwer C L, Langendijk J A, van Dijk L V
Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Machine Learning Lab, Data Science Center in Health (DASH), Groningen, the Netherlands.
Radiother Oncol. 2025 Apr;205:110746. doi: 10.1016/j.radonc.2025.110746. Epub 2025 Jan 28.
BACKGROUND/PURPOSE: Taste impairment is a common yet complex toxicity of head and neck cancer (HNC) radiotherapy treatment that may affect quality of life of survivors. This study aimed to predict acute and late taste impairment using taste bud bearing tongue mucosa as a new taste-specific organ-at-risk compared to full oral cavity as identified in previous studies.
MATERIALS/METHODS: Included HNC patients were treated with curative radiotherapy between 2007 and 2022. The endpoint was patient-rated moderate-to-severe taste loss scored with the EORTC QLQ-H&N35. The new tongue mucosa structure was derived from the existing oral cavity structure in accordance with published guidelines. An auto-segmentation tool was developed and verified by comparison to manually delineated structures. The performance of the mean dose admitted to this new structure was evaluated with both univariable analysis and a refit of a reference NTCP model substituting the oral cavity with the tongue mucosa.
A total of 691 HNC patients were included. Good conformity between manually delineated and auto-segmented structures was observed with no significant differences in mean dose (22.2 Gy vs. 22.1 Gy) or volume (20.7 cm vs. 20.3 cm). Full oral cavity mean dose showed comparable effect size in univariable analysis compared to tongue mucosa mean dose. The NTCP model with tongue mucosa did not outperform the reference model with oral cavity for any evaluated time points.
The tongue mucosa mean dose did not outperform the oral cavity mean dose in the logistic regression NTCP model predicting acute and late taste impairment.
背景/目的：味觉障碍是头颈癌（HNC）放射治疗常见但复杂的毒性反应，可能影响幸存者的生活质量。本研究旨在以味蕾舌黏膜作为一种新的特定味觉危及器官，与先前研究中确定的全口腔相比，预测急性和晚期味觉障碍。
材料/方法：纳入2007年至2022年间接受根治性放疗的HNC患者。终点是患者根据欧洲癌症研究与治疗组织（EORTC）QLQ-H&N35量表评定的中度至重度味觉丧失。新的舌黏膜结构是根据已发表的指南从现有的口腔结构衍生而来。开发了一种自动分割工具，并通过与手动勾勒的结构进行比较进行验证。通过单变量分析和对参考正常组织并发症概率（NTCP）模型进行重新拟合（用舌黏膜替代口腔）来评估该新结构所接受的平均剂量的性能。
共纳入691例HNC患者。观察到手动勾勒和自动分割的结构之间具有良好的一致性，平均剂量（22.2 Gy对22.1 Gy）或体积（20.7 cm对20.3 cm）无显著差异。在单变量分析中，全口腔平均剂量与舌黏膜平均剂量显示出相当的效应量。在任何评估时间点，采用舌黏膜的NTCP模型均未优于采用口腔的参考模型。
在预测急性和晚期味觉障碍的逻辑回归NTCP模型中，舌黏膜平均剂量并未优于口腔平均剂量。
