The effect of concomitant chemotherapy on parotid gland function following head and neck IMRT
| Autor: | Sarah L. Gulliford, Kate Newbold, Shreerang Bhide, Christopher M. Nutting, Kevin J. Harrington, Shane Zaidi, Aisha Miah |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Saliva medicine.medical_treatment Xerostomia stomatognathic system otorhinolaryngologic diseases medicine Humans Parotid Gland Radiology Nuclear Medicine and imaging Prospective cohort study neoplasms Aged Aged 80 and over Chemotherapy business.industry Squamous Cell Carcinoma of Head and Neck Incidence (epidemiology) Incidence Hematology Chemoradiotherapy Parotid gland Surgery Radiation therapy stomatognathic diseases medicine.anatomical_structure Oncology Head and Neck Neoplasms Concomitant Carcinoma Squamous Cell Female Radiotherapy Intensity-Modulated Nuclear medicine business therapeutics |
| Zdroj: | Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 106(3) |
| ISSN: | 1879-0887 |
| Popis: | Purpose: To determine whether concomitant chemotherapy increases the incidence of high grade xerostomia following parotid-sparing intensity-modulated radiotherapy (IMRT) in patients with locally advanced head and neck squamous cell cancer. Materials and methods: The incidence of high grade (PG2) acute (CTCAEv3.0) and late (LENTSOMA and RTOG) xerostomia was compared between patients treated with either IMRT or concomitant chemoIMRT (c-IMRT) in 2 prospective studies. Parotid gland mean tolerance doses (D50) were reported using non-linear logistic regression analysis. Results: Thirty-six patients received IMRT alone and 60 patients received c-IMRT. Patients received 65 Gy in 30 daily fractions to the primary site and involved nodal groups and 54 Gy in 30 fractions to elective nodal groups, mean doses to the parotid glands were comparable. Concomitant cisplatin 100 mg/m 2 was administered on days 1 and 29 of IMRT. The incidence of PG2 subjective xerostomia was similar in both groups; acute-64.7% (IMRT) versus 60.3% (c-IMRT), p = 0.83; late-43% (IMRT) versus 34% (c-IMRT), p = 0.51. Recovery of parotid salivary flow at 1 year was higher with IMRT (64% vs 50%), but not statistically significant (p = 0.15). D50 for absence of parotid saliva flow at 1 year was 23.2 Gy (95% CI: 17.7–28.7) for IMRT and 21.1 Gy (11.8–30.3) for c-IMRT. Conclusion: Concomitant c-IMRT does not increase the incidence of acute or late xerostomia relative to IMRT alone. 2013 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 106 (2013) 346–351 |
| Databáze: | OpenAIRE |
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