A BSTRACT Background: In locally advanced Laryngeal and hypopharyngeal cancer, definitive chemoradiation therapy has become the preferred treatment owing to its organ preservation advantages. It is recognized for inducing considerable short- and long-term toxicity when administered at extreme dosages. Research indicates that patients undergoing radiation therapy (RT) in conjunction with chemotherapy experienced more severe toxicity, such as mucositis. Associated radiation exposure to the buccal mucosa during treatment with radiation for carcinomas of the larynx and pharynx leads to acute radiation-induced oral mucositis (RIOM). Objectives: To assess the dose received by buccal mucosa and oral mucositis in patients receiving combined chemoradiation for treatment of laryngeal and hypopharyngeal cancers with volumetric modulated arc therapy (VMAT). Materials and Methods: Forty-five patients with histologically proven squamous cell carcinoma of the larynx and hypopharyx cancer, who received chemoradiation therapy by VMAT were analyzed. The total prescribed dose was 70 Gy delivered in 2 Gy daily fractions with concurrent weekly injection cisplatin (35 mg/m 2 )/carboplatin area under the curve 2 (AUC 2). Dosimetric parameters of right and left buccal mucosa (V 15 Gy and V 30 Gy) were recorded and correlated with grades of RIOM as per CTCAE v5.0. Results: Mucositis and weight loss were assessed from week 1 to 7. Grade 2 and 3 mucositis was observed in 66.7% ( n = 30) and 4.4% ( n = 2). None of the patients developed Grade 4 or more. Weight loss of Grade 2 and 3 was observed in 42.2% ( n = 19) and 57.8 ( n = 26). Increase in dose to buccal mucosa showed a significant ( P < 0.001) with oral mucositis. Conclusion: The incidence of various RIOM was evaluated in this study as a predictor of the dosage administered to the buccal mucosa in patients with laryngeal and hypopharyngeal cancer. In HNCs receiving radical chemoradiation therapy, our data showed a correlation between buccal mucosa V15Gy and V30Gy and oral mucosal toxicity.
Roshni et al. (Fri,) studied this question.