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.
背景：约75%的头颈部肿瘤患者接受放射治疗（RT）。口腔区域的放疗会导致急性和晚期不良事件，这些事件可能严重影响患者的生活质量和功能。本研究旨在探讨特定口腔风险器官（OAR）避让结构的放疗剂量与临床医生报告结局、患者报告结局（PROs）、阿片类药物使用及住院情况之间的关联。方法：本研究采用前瞻性数据收集与多变量模型进行回顾性分析。共纳入196例因头颈部肿瘤接受口腔区域放疗的患者。所有患者的放疗计划均采用统一的口腔OAR避让结构。研究前瞻性收集了经过验证的PROs数据，并通过电子病历系统提取阿片类药物使用及住院信息。结果：多变量模型分析显示，口腔OAR的平均放疗剂量与治疗期间及治疗结束后30天内的阿片类药物使用（p=0.0082）和住院需求（p=0.0356）存在显著关联。结论：本研究结果对头颈部肿瘤患者的放疗计划制定具有重要价值，有助于降低治疗期间对阿片类药物的依赖及住院需求。
肿瘤(癌症)患者之家