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

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.

Comparison of toxicity associated with early morning versus late afternoon radiotherapy in patients with head-and-neck cancer: a prospective randomized trial of the National Cancer Institute of Canada Clinical Trials Group (HN3).

Purpose: Based on our demonstration of a circadian rhythm in the human oral mucosa cell cycle, with most cells in the G(1) phase in the morning and M phase at night, we hypothesized that morning radiotherapy (RT) would lead to less oral mucositis than afternoon RT.

Methods And Materials: A total of 216 patients were randomized to morning (8-10 AM) vs. afternoon (4-6 PM) RT and stratified by radiation dose, smoking status, and center.