Acute-phase response reactants as objective biomarkers of radiation-induced mucositis in head and neck cancer.

Fazilat F Mohammed, Ian Poon, Liying Zhang, Liz Elliott, Ian D Hodson, Stephen M Sagar, James Wright

Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Head & neck 2012 Jul

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Current evaluation of radiation-induced mucositis in head and neck cancer relies on subjective scoring with interrater variability. We evaluated serum erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) as objective markers of radiation-induced mucositis. Weekly serum CRP and ESR levels were measured in patients treated for head and neck cancer with radiation ± chemotherapy. Acute radiation toxicity was evaluated using National Cancer Institute of Canada-Common Toxicity Criteria (NCIC-CTC) version 2.0 and the Head and Neck Radiotherapy Questionnaire (HNRQ). ESR and CRP levels were significantly elevated by 3 weeks (p = .01) and 6 weeks (p = .0002), respectively, and independent of age or pretreatment surgery. ESR was significantly dependent on radiation dose (p = .0004) and significantly higher with chemoradiation (p = .03). Serum ESR and CRP rise reliably in a radiation dose-dependent manner. ESR correlated with clinical symptoms and distinguished patients receiving chemoradiation. ESR and CRP may be an objective and sensitive marker of radiation-induced mucositis. Copyright © 2011 Wiley Periodicals, Inc.

Citation

Fazilat F Mohammed, Ian Poon, Liying Zhang, Liz Elliott, Ian D Hodson, Stephen M Sagar, James Wright. Acute-phase response reactants as objective biomarkers of radiation-induced mucositis in head and neck cancer. Head & neck. 2012 Jul;34(7):985-93