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Related Experiment Video

Updated: Jul 8, 2026

Diffuse Optical Spectroscopy for the Quantitative Assessment of Acute Ionizing Radiation Induced Skin Toxicity Using a Mouse Model
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Published on: May 27, 2016

Measurement Tools for Radiation-Induced Fibrosis in Head and Neck Cancer: A Systematic Review.

Vanessa Helou1, Pooja D Reddy2, Purva H Rumde2

  • 1Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Head & Neck
|July 2, 2026
PubMed
Summary

This review found reliable and valid subjective tools for measuring radiation-induced fibrosis in head and neck cancer (HNC) patients. Young's modulus is the sole objective imaging tool with proven validity and reliability, despite some limitations.

Keywords:
fibrosis measurementhead and neck cancerradiation‐induced fibrosissystematic review

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Area of Science:

  • Oncology
  • Radiotherapy
  • Medical Imaging

Background:

  • Radiation-induced fibrosis is a frequent and disabling consequence of head and neck cancer (HNC) treatment.
  • Accurate measurement tools are crucial for managing this late effect.
  • An updated systematic review is needed to assess current fibrosis measurement tools.

Purpose of the Study:

  • To systematically review and evaluate the reliability, validity, and clinical utility of measurement tools for radiation-induced fibrosis in HNC.
  • To identify the most dependable tools for assessing fibrosis in HNC patients post-treatment.

Main Methods:

  • A systematic literature search was conducted across multiple databases (Cochrane Library, Medline, Embase.com, Web of Science).
  • Two independent reviewers screened articles using COSMIN checklists for risk of bias assessment.
  • PRISMA guidelines were followed for study selection and reporting.

Main Results:

  • Seventeen studies describing 13 distinct tools met the inclusion criteria.
  • Four patient-reported outcome measures, two clinician-reported tools, and seven imaging modalities were evaluated.
  • The Neck Fibrosis Scale, HN-LEF Symptom Inventory, and LENT-SOMA showed good reliability and validity.
  • Young's modulus was the only imaging tool demonstrating both reliability and validity.
  • Imaging studies exhibited a higher risk of bias compared to subjective measures.

Conclusions:

  • Subjective tools, including the Neck Fibrosis Scale, HN-LEF Symptom Inventory, and LENT-SOMA, are reliable and valid for assessing radiation-induced fibrosis in HNC.
  • Young's modulus is the only objective, imaging-based tool with evidence of validity and reliability.
  • Methodological limitations persist, particularly in imaging-based assessments, warranting further research.