Volume 33, Issue 2 (Avicenna Journal of Clinical Medicine-Summer 2026)
Avicenna J Clin Med 2026, 33(2): 74-82 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Saber K, Jalili M R, Roayaei M. Identifying Predictors of Radiation-Induced Esophagitis in Head and Neck Cancers: A Logistic Regression-Based Study. Avicenna J Clin Med 2026; 33 (2) :74-82
URL: http://sjh.umsha.ac.ir/article-1-3378-en.html
URL: http://sjh.umsha.ac.ir/article-1-3378-en.html
1- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3- Department of Radiation Oncology, Isfahan University of Medical Sciences, Isfahan, Iran ,roayaeimahnaz@gmail.com
2- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3- Department of Radiation Oncology, Isfahan University of Medical Sciences, Isfahan, Iran ,
Abstract: (64 Views)
Background and Objective: Radiation-induced esophagitis is a common and treatment-limiting complication in patients with head and neck cancers, which can significantly impact quality of life, nutritional status, and treatment continuity. The present prospective study aimed to identify independent predictors of grade ≥1 radiation-induced esophagitis in patients with head and neck cancers using binary logistic regression.
Materials and Methods: This prospective study was conducted on 50 patients with head and neck cancer undergoing intensity-modulated radiation therapy at Seyed-o-Shohada Hospital, Isfahan, Iran, during 2024–2025. Esophagitis severity was graded according to the Radiation Therapy Oncology Group criteria. Univariate and multivariate analyses were performed using binary logistic regression. Multicollinearity among variables was assessed using Pearson's correlation matrix.
Results: Among the 50 patients, 28 (56%) experienced at least grade 1 esophagitis. Mean esophagus dose was identified as the sole independent and statistically significant predictor in the multivariate model (P = 0.007; OR = 1.11, 95% CI: 1.03–1.20). Although tumor stage was significant in univariate analysis (P = 0.008), it was no longer significant after adjusting for mean esophagus dose in the multivariate model (P = 0.457). Demographic variables, including age, sex, body mass index, smoking history, and concurrent chemotherapy, showed no significant association. The Nagelkerke R² was 0.242, and the area under the receiver operating characteristic curve was 0.746, indicating acceptable discriminatory power.
Conclusion: Mean esophageal dose is the strongest and only independent predictor of radiation-induced esophagitis in patients with head and neck cancers. Emphasizing this dosimetric parameter during treatment planning may help reduce radiotherapy complications and improve patients' quality of life.
Materials and Methods: This prospective study was conducted on 50 patients with head and neck cancer undergoing intensity-modulated radiation therapy at Seyed-o-Shohada Hospital, Isfahan, Iran, during 2024–2025. Esophagitis severity was graded according to the Radiation Therapy Oncology Group criteria. Univariate and multivariate analyses were performed using binary logistic regression. Multicollinearity among variables was assessed using Pearson's correlation matrix.
Results: Among the 50 patients, 28 (56%) experienced at least grade 1 esophagitis. Mean esophagus dose was identified as the sole independent and statistically significant predictor in the multivariate model (P = 0.007; OR = 1.11, 95% CI: 1.03–1.20). Although tumor stage was significant in univariate analysis (P = 0.008), it was no longer significant after adjusting for mean esophagus dose in the multivariate model (P = 0.457). Demographic variables, including age, sex, body mass index, smoking history, and concurrent chemotherapy, showed no significant association. The Nagelkerke R² was 0.242, and the area under the receiver operating characteristic curve was 0.746, indicating acceptable discriminatory power.
Conclusion: Mean esophageal dose is the strongest and only independent predictor of radiation-induced esophagitis in patients with head and neck cancers. Emphasizing this dosimetric parameter during treatment planning may help reduce radiotherapy complications and improve patients' quality of life.
Type of Study: Original |
Subject:
Radiotherapy
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Articles Copyright © The Author(s).
Owned by Hamadan University of Medical Sciences
Published by UMSHA Press
Journal Tel: +988138380924
Publisher Tel:+988138382022
Website: http://sjh.umsha.ac.ir
Email: s_ journal[at]umsha.ac.ir
