Genetic variants associated with mandibular osteoradionecrosis following radiotherapy for head and neck malignancy

Brooker, Rachel C ORCID: 0000-0002-0668-6889, Antczak, Philipp ORCID: 0000-0001-9600-7757, Liloglou, Triantafillos ORCID: 0000-0003-0460-1404, Risk, Janet M ORCID: 0000-0002-8770-7783, Sacco, Joseph J, Schache, Andrew G ORCID: 0000-0001-9466-6038 and Shaw, Richard J ORCID: 0000-0002-5157-4042 (2021) Genetic variants associated with mandibular osteoradionecrosis following radiotherapy for head and neck malignancy. Radiotherapy and Oncology, 165. pp. 87-93. (In Press)

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Abstract

<h4>Background/aim</h4>Utilising radiotherapy in the management of head and neck cancer (HNC) often results in long term toxicities. Mandibular osteoradionecrosis (ORN) represents a late toxicity associated with significant morbidity. We aim to identify a panel of common genetic variants which can predict ORN to aid development of personalised radiotherapy protocols.<h4>Method</h4>Single nucleotide polymorphism (SNP) arrays were applied to DNA samples from patients who had prior HNC radiotherapy and minimum two years follow-up. A case cohort of mandibular ORN was compared to a control group of participants recruited to CRUK HOPON clinical trial. Relevant clinical parameters influencing ORN risk (e.g. smoking/alcohol) were collected. Significant associations from array data were internally validated using polymerase chain reaction (PCR) and pyrosequencing.<h4>Results</h4>Following inclusion of 141 patients in the analysis (52 cases, 89 controls), a model predictive for ORN was developed; after controlling for alcohol consumption, smoking, and age, 4053 SNPs were identified as significant. This was reduced to a representative model of 18 SNPs achieving 92% accuracy. Following internal technical validation, a six SNP model (rs34798038, rs6011731, rs2348569, rs530752, rs7477958, rs1415848) was retained within multivariate regression analysis (ROC AUC 0.859). Of these, four SNPs (rs34798038 (A/G) (p 0.006), rs6011731 (C/T) (p 0.018), rs530752 (A/G) (p 0.046) and rs2348569 (G/G) (p 0.005)) were significantly associated with the absence of ORN.<h4>Conclusion</h4>This is the first genome wide association study in HNC using ORN as the endpoint and offers new insight into ORN pathogenesis. Subject to validation, these variants may guide patient selection for personalised radiotherapy strategies.

Item Type:	Article
Uncontrolled Keywords:	Head and neck cancer, Radiotherapy, Osteoradionecrosis, Mandible, Single nucleotide polymorphism, Genome wide association studies
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User:	Symplectic Admin
Date Deposited:	17 Nov 2021 09:38
Last Modified:	18 Jan 2023 21:24
DOI:	10.1016/j.radonc.2021.10.020
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3143299