Oral Mucositis Severity and Predictive Biomarkers in Head and Neck Cancer Patients Treated with Concurrent Chemoradiotherapy: A Single-Institution Retrospective Cohort Study

Authors

• Srishti Seth, Mercer UniversityFollow
• Md Mahin, The University of Texas MD Anderson Cancer CenterFollow
• Mai Mandor Badawy, The University of Texas MD Anderson Cancer CenterFollow
• Eric Ababio Anyimadu, The University of Texas MD Anderson Cancer CenterFollow
• Cem Dede, The University of Texas MD Anderson Cancer CenterFollow
• Clifton David Fuller, The University of Texas MD Anderson Cancer CenterFollow
• Amy Catherine Moreno, The University of Texas MD Anderson Cancer CenterFollow
• Busra Yilmaz, The University of Texas MD Anderson Cancer CenterFollow

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Description

Oral mucositis is one of the most prevalent and debilitating acute toxicities of radiotherapy-based treatment for patients with head and neck cancer (HNC) receiving concurrent chemoradiotherapy (CRT). Although it contributes to treatment interruptions, increased opioid use, nutritional compromise, and reduced quality of life, the ability to predict which patients will develop severe mucositis prior to or early in treatment remains limited. We aim to describe the incidence and severity of oral mucositis, measured by the MD Anderson Symptoms Inventory (MDASI) across treatment weeks in this cohort and analyze biological factors for mucositis, including biomarkers in the CBC with differential.

This retrospective single-institution study analyzes a cohort of 169 Head and Neck cancer patients who have received concurrent CRT. Oral mucositis severity was assessed weekly using the MDASI, and a subset of 88 had complete weekly CBC data available for biomarker analysis. Statistical analysis were performed using Python.

93% of patients with oropharynx cancer received above the median RT dose (6600 cGy). Hematology values measured decreased throughout each successive week of treatment for both RT dose stratifications. Although Basophils and Eosinophils were comparable between the RT doses received, there were slight differences in other values such as RBC and HGB. MDASI weekly survey responses demonstrate an increased severity in symptoms of pain, dysphagia, and mouth/throat sores during subsequent treatments. For all three symptoms measured (pain, dysphagia, and mouth/throat sores), the average patient-reported symptom ratings were overall similar between the stratified RT doses.

By examining the relationship between these parameters and mucositis, we aim to better understand the biological and clinical factors that influence mucositis development and facilitate risk stratification for patients. This can lead to tailored interventions for patients, potentially reducing treatment-related complications.

Program Affiliation

SOAR

Publication Date

Summer 7-20-2026

Recommended Citation

Seth, Srishti; Mahin, Md; Badawy, Mai Mandor; Anyimadu, Eric Ababio; Dede, Cem; Fuller, Clifton David; Moreno, Amy Catherine; and Yilmaz, Busra, "Oral Mucositis Severity and Predictive Biomarkers in Head and Neck Cancer Patients Treated with Concurrent Chemoradiotherapy: A Single-Institution Retrospective Cohort Study" (2026). Students Summer in Oncology at Anderson Research (SOAR) 2026. 1.
https://openworks.mdanderson.org/soar26/1