Meta-GWAS identifies the heritability of acute radiation-induced toxicities in head and neck cancer

•Acute radiation-induced toxicities (RITS) are heritable phenotypes and ∼29% of their variances are explained by common genetic variants.•Three potential novel mechanisms for RITs are exoribonuclease activity, inositol phosphate-mediated signaling, and drug catabolic process.•Using genetic markers is effective to understand the mechanism of acute RITs, and to predict acute RITs by employing polygenic risk scores.•Genetically enriched prediction model for RITs followed by radiation-dose adjustment contributes to attaining personalized radiotherapy.