Recovery of Salivary Function: Contralateral Parotid-sparing Intensity-modulated Radiotherapy versus Bilateral Superficial Lobe Parotid-sparing Intensity-modulated Radiotherapy

Autor: Shreerang Bhide, Aisha Miah, Sarah L. Gulliford, James P Morden, Kevin J. Harrington, Shane Zaidi, Katie L. Newbold, Emma Hall, Christopher M. Nutting
Rok vydání: 2016
Předmět:
Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Locally advanced
Parotid sparing
Xerostomia
Salivary function
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
otorhinolaryngologic diseases
medicine
Humans
Parotid Gland
Radiology
Nuclear Medicine and imaging
IMRT
Head and neck cancer
neoplasms
Aged
integumentary system
Squamous Cell Carcinoma of Head and Neck
business.industry
Middle Aged
medicine.disease
Lobe
Parotid gland
Surgery
Radiation therapy
stomatognathic diseases
medicine.anatomical_structure
Oncology
Radiology Nuclear Medicine and imaging
Head and Neck Neoplasms
030220 oncology & carcinogenesis
Carcinoma
Squamous Cell
Original Article
Female
Radiotherapy
Intensity-Modulated
Radiology
Intensity modulated radiotherapy
business
therapeutics
Zdroj: Clinical Oncology (Royal College of Radiologists (Great Britain)
ISSN: 0936-6555
DOI: 10.1016/j.clon.2016.02.009
Popis: Aims To establish whether there is a difference in recovery of salivary function with bilateral superficial lobe parotid-sparing intensity-modulated radiotherapy (BSLPS-IMRT) versus contralateral parotid-sparing IMRT (CLPS-IMRT) in patients with locally advanced head and neck squamous cell cancers. Materials and methods A dosimetric analysis was carried out on data from two studies in which patients received BSLPS-IMRT (PARSPORT II) or CLPS-IMRT (PARSPORT). Acute (National Cancer Institute, Common Terminology Criteria for adverse events – NCI CTCAEv3.0) and late (Late Effects of Normal Tissue- subjective, objective, management analytical – LENTSOMA and Radiation Therapy Oncology Group) xerostomia scores were dichotomised: recovery (grade 0–1) versus no recovery (≥grade 2). Incidence of recovery of salivary function was compared between the two techniques and dose-response relationships were determined by fitting dose-response curves to the data using non-linear logistic regression analysis. Results Seventy-one patients received BSLPS-IMRT and 35 received CLPS-IMRT. Patients received 65 Gy in 30 fractions to the primary site and involved nodal levels and 54 Gy in 30 fractions to elective nodal levels. There were significant differences in mean doses to contralateral parotid gland (29.4 Gy versus 24.9 Gy, P
Highlights • Two different parotid gland sparing IMRT techniques are described. • Bilateral superficial lobe parotid sparing IMRT may reduce high grade xerostomia compared to contralateral parotid sparing IMRT.
Databáze: OpenAIRE
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