Original Article

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

  1. Fazilat F. Mohammed MD, PhD1,
  2. Ian Poon MD1,*,
  3. Liying Zhang PhD1,
  4. Liz Elliott BSc2,
  5. Ian D. Hodson MD, PhD2,
  6. Stephen M. Sagar MD2,
  7. James Wright MD2

Article first published online: 26 SEP 2011

DOI: 10.1002/hed.21848

Additional Information

How to Cite

Mohammed, F. F., Poon, I., Zhang, L., Elliott, L., Hodson, I. D., Sagar, S. M. and Wright, J. (2011), Acute-phase response reactants as objective biomarkers of radiation-induced mucositis in head and neck cancer. Head Neck. doi: 10.1002/hed.21848

Author Information

  1. 1

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

  2. 2

    Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada

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

  1. †

    This study was supported by the Juravinski Cancer Centre Foundation.

Publication History

  1. Article first published online: 26 SEP 2011
  2. Manuscript Accepted: 19 MAY 2011

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Keywords:

  • ESR;
  • CRP;
  • head and neck cancer;
  • mucositis

Abstract

Background

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.

Methods

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).

Results

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).

Conclusion

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. © 2011 Wiley Periodicals, Inc. Head Neck, 2011

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