Clinical and dosimetric predictors of physician and patient reported xerostomia following intensity modulated radiotherapy for nasopharyngeal cancer – A prospective cohort analysis

Autor: James B. K. Khoo, Kiattisa Sommat, Ashik Hussain, Yoke Lim Soong, K.W. Fong, Joseph Wee, Nelson Ling Fung Yit, Whee Sze Ong, Terence Wee Kiat Tan
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Xerostomia
030218 nuclear medicine & medical imaging
Cohort Studies
Young Adult
03 medical and health sciences
Clinical Trials
Phase II as Topic
0302 clinical medicine
stomatognathic system
Surveys and Questionnaires
otorhinolaryngologic diseases
medicine
Clinical endpoint
Humans
Parotid Gland
Radiology
Nuclear Medicine and imaging
Patient Reported Outcome Measures
Prospective Studies
Radiation Injuries
Prospective cohort study
Aged
Randomized Controlled Trials as Topic
Nasopharyngeal cancer
Chemotherapy
Nasopharyngeal Carcinoma
business.industry
Incidence (epidemiology)
Dose-Response Relationship
Radiation
Nasopharyngeal Neoplasms
Hematology
Middle Aged
Dry mouth
medicine.disease
stomatognathic diseases
Clinical Trials
Phase III as Topic
Oncology
Nasopharyngeal carcinoma
030220 oncology & carcinogenesis
Female
Radiotherapy
Intensity-Modulated
Radiology
Intensity modulated radiotherapy
medicine.symptom
business
Zdroj: Radiotherapy and Oncology. 138:149-157
ISSN: 0167-8140
DOI: 10.1016/j.radonc.2019.05.023
Popis: Background and purpose To compare physician and patient reported xerostomia and correlate xerostomia with dosimetric and clinical parameters for nasopharyngeal cancer (NPC) patients treated with intensity modulated radiotherapy (IMRT) and chemotherapy. Patients and methods We analyzed the data of 172 patients with locally advanced NPC. Xerostomia was evaluated via physician-rated xerostomia based on RTOG morbidity score (E1), patient-rated dry mouth (E2) and patient-rated sticky saliva (E3) based on EORTC QLQ-HN35 questionnaire. Primary endpoint was the presence of moderate to severe xerostomia at 2-year after completion of IMRT. Results The levels of physician reported xerostomia (E1) were consistently lower than patient reported dry mouth (E2) over time. The incidence of patients with xerostomia at 3-month post RT was 58% based on E1, 70% based on E2, and 51% based on E3. The corresponding incidence rates at 2-year post RT was 26% (E1), 36% (E2) and 21% (E3). The incidence of patients with xerostomia at 1-year post RT was close to that at 2-year post RT for all the 3 endpoints. The average Dmean of parotid glands was 41.5 Gy (range: 31.0 Gy-65.9 Gy, median: 40.7 Gy). No dosimetric parameters were significantly associated with xerostomia. Conclusion Significant proportion of patients still experienced long term xerostomia with IMRT. Dose-effect relationships between xerostomia and the parotid glands were not observed in this study.
Databáze: OpenAIRE
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