Predictive factors of oral mucositis in patients with locally recurrent inoperable head and neck cancer treated with boron neutron capture therapy

Authors

  • Tanja Mälkiä Department of Radiation Oncology, Helsinki University Hospital Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland https://orcid.org/0009-0003-4131-7100
  • Hanna Koivunoro Department of Radiation Oncology, Helsinki University Hospital Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland; Neutron Therapeutics Finland Oy, Helsinki, Finland https://orcid.org/0000-0001-8189-9115
  • Tiina Seppälä Department of Radiation Oncology, Helsinki University Hospital Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland https://orcid.org/0000-0003-1358-2620
  • Leena Kankaanranta Department of Radiation Oncology, Helsinki University Hospital Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland https://orcid.org/0000-0002-4831-0732
  • Liisa Porra Department of Radiation Oncology, Helsinki University Hospital Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland https://orcid.org/0000-0003-3639-944X
  • Anu Anttonen Department of Radiation Oncology, Helsinki University Hospital Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland https://orcid.org/0000-0002-3925-8629
  • Mikko Tenhunen Department of Radiation Oncology, Helsinki University Hospital Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland https://orcid.org/0000-0003-3786-5684
  • Heikki Joensuu Department of Radiation Oncology, Helsinki University Hospital Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland https://orcid.org/0000-0003-0281-2507

DOI:

https://doi.org/10.2340/1651-226X.2025.44039

Keywords:

boron neutron capture therapy, BNCT, oral mucositis, head and neck cancer, radiation therapy

Abstract

Background and purpose: The prognosis of recurrent head and neck (HN) cancer is poor. High response rates have been achieved with boron neutron capture therapy (BNCT) in the treatment of locally recurrent HN cancer. Radiation-induced oral mucositis (OM) is a common adverse effect of BNCT. We evaluated the factors associated with severe OM in patients treated with BNCT.

Patient/material and methods: Ninety two patients with locally recurrent inoperable HN cancer were treated with nuclear reactor-based BNCT in 1–2 fractions. The association between grade 3 OM, patient clinical parameters and maximum weighted oral mucosa dose was evaluated. Mucosal dose was calculated using the skin nitrogen concentration of 4.2%. A sigmoidal normal tissue complication probability (NTCP) model was created by dividing patients into four equal sized groups based on increasing dose levels.

Results: Grade 3 OM was observed in 42% of patients after the first BNCT treatment. The prevalence of OM increased with higher maximum oral mucosa doses. From the NTCP curve, we estimated the dose corresponding to a 50% probability (D50) for grade 3 OM to be 13.5 Gy(W). Older age was the only patient-
related factor significantly associated with increased grade 3 OM risk.

Interpretation: Higher maximum oral mucosa doses increased the risk of grade 3 OM. Older age was the only other factor related to severe OM.

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Published

2025-09-23

How to Cite

Mälkiä, T., Koivunoro, H., Seppälä, T., Kankaanranta, L., Porra, L., Anttonen, A., … Joensuu, H. (2025). Predictive factors of oral mucositis in patients with locally recurrent inoperable head and neck cancer treated with boron neutron capture therapy. Acta Oncologica, 64, 1307–1311. https://doi.org/10.2340/1651-226X.2025.44039

Issue

Vol. 64 (2025): Acta Oncologica

Section

Short report

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Copyright (c) 2025 Tanja Mälkiä, Hanna Koivunoro, Tiina Seppälä, Leena Kankaanranta, Liisa Porra, Anu Anttonen, Mikko Tenhunen, Heikki Joensuu

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This work is licensed under a Creative Commons Attribution 4.0 International License.