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Abstract
An automated radiation modulator (ARM) was developed to enable a high-throughput radiation sensitivity test
using patient-derived organoids (PDOs) as an in vitro diagnostic device. Treatment strategies for head and neck
cancer include surgery and radiotherapy. However, patient responses to radiotherapy vary widely. To overcome
limitations in efficiency and scalability, the ARM was developed to provide controlled, reproducible, and high-
throughput radiation delivery. Its feasibility was validated by comparing it with conventional radiation methods
using two HNSCC cell lines, as well as by applying it to PDO-based radiation sensitivity tests. The ARM suc
cessfully classified head and neck cancer PDOs into radiation-sensitive and radiation-resistant groups.
OncoSensi, a radiation sensitivity screening method utilizing the ARM, was cross-validated with clinical
radiotherapy outcomes, including recurrence status, in 14 patients with head and neck cancer. The multi-
parameter OncoSensi model achieved a sensitivity of 80% and a specificity of 75%, demonstrating superior
predictive performance compared to the single-parameter model, which yielded a sensitivity of 70% and a
specificity of 50%. Statistically significant difference in recurrence-free survival (RFS) was observed between the
OncoSensi-sensitive and -resistant groups. Therefore, ARM-based radiation sensitivity screening can serve as a
practical tool for implementing precision medicine in radiotherapy for patients with head and neck cancer, ul
timately contributing to improved treatment efficacy and patient prognosis.