Delta-Radiomic Kinetics of Parotid Glands on Weekly CBCT Predict Late Xerostomia After Head-Neck Radiotherapy

SVM integrating weekly CBCT delta-radiomic kinetics predicted late xerostomia at week 4 with AUC 0.81 (p=0.002), sensitivity 100%, specificity 86% (retrospective, n=131).

• Retrospective study of 131 head-and-neck cancer patients treated with VMAT; training (n=91) and testing (n=40) sets.
• Texture-based GLCM features (AUC 0.79) outperformed first-order/morphological features; optimal prediction at mid-treatment (week 4).
• Single-center retrospective design without external validation; requires prospective confirmation.

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