Mean Oral Cavity Organ-at-Risk Dose Predicts Opioid Use and Hospitalization during Radiotherapy for Patients with Head and Neck Tumors

Simple Summary Approximately 75% of all head and neck cancer patients are treated with radiotherapy. Radiotherapy to the oral cavity results in acute and late adverse events which can be severe depending on the outcome measured and intensity of the treatment. These adverse events are detrimental to the patient's quality of life and function and are costly to manage. The aim of this retrospective study was to evaluate the association between radiotherapy dose to a defined oral cavity organ-at-risk avoidance structure and prospectively obtained validated provider- and patient-reported outcomes, opioid use, and hospitalization in 196 patients treated with radiotherapy for tumors in the head and neck region. We identified a statistically significant association between radiotherapy dose to the oral cavity organ-at-risk structure, opioid use, and hospitalization. This association provides valuable information for radiotherapy treatment planning to allow for reduction in adverse events.Abstract Background: Approximately 75% of all head and neck cancer patients are treated with radiotherapy (RT). RT to the oral cavity results in acute and late adverse events which can be severe and detrimental to a patient's quality of life and function. The purpose of this study was to explore associations between RT dose to a defined oral cavity organ-at-risk (OAR) avoidance structure, provider- and patient-reported outcomes (PROs), opioid use, and hospitalization. Methods: This was a retrospective analysis of prospectively obtained outcomes using multivariable modeling. The study included 196 patients treated with RT involving the oral cavity for a head and neck tumor. A defined oral cavity OAR avoidance structure was used in all patients for RT treatment planning. Validated PROs were collected prospectively. Opioid use and hospitalization were abstracted electronically from medical records. Results: Multivariable modeling revealed the mean dose to the oral cavity OAR was significantly associated with opioid use (p = 0.0082) and hospitalization (p = 0.0356) during and within 30 days of completing RT. Conclusions: The findings of this study may be valuable in RT treatment planning for patients with tumors of the head and neck region to reduce the need for opioid use and hospitalization during treatment.