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Relationship between radiation-induced xerostomia and the volume of parotid glands exposed in radiotherapy for nasopharyngeal carcinoma
Liu Yang, Ma Jie, Yang Yunli, Li Ling, Zhu Xiaodong
Department of Radiation Oncology,Affiliated Tumor Hospital of Guangxi Medical University,Nanning 530021,China (Liu Y,Yang YL,Li L,Zhu XD);Medical Imaging Diagnosis Center,Affiliated Tumor Hospital of Guangxi Medical University,Nanning 530021,China (Ma J)
AbstractObjective To evaluate the relationship between the volume of parotid glands and radiation-induced xerostomia in patients with nasopharyngeal carcinoma (NPC). Methods A total of 199 patients with NPC who were admitted to our hospital from 2015 to 2016 were enrolled as subjects. According to the initial volume of parotid glands, all patients were divided into large parotid group and small parotid group. The incidence of xerostomia after radiotherapy and dosimetric parameters were compared between the two groups. Comparison of categorical data was made by χ2 test. Comparison of continuous data was made by t-test or nonparametric test. Comparison of dose-volume histogram index was made by nonparametric test. Results There was no difference in the severity of xerostomia between the two groups at 3 and 6 months after radiotherapy. At one year after radiotherapy,the large parotid group had significantly milder xerostomia than the small parotid group (P=0.035).The small parotid group had a higher dose delivered to both parotid glands than the large parotid group. There was no difference in the mean dose to the submandibular gland between the two groups. Conclusions The initial volume of parotid glands is one of the influencing factors for the grade of xerostomia after radiotherapy. Patients with large parotid glands have better recovery from xerostomia after radiotherapy than those with small parotid glands. For patients with small parotid glands, more attention should be paid to reducing the dose to protect parotid glands.
Liu Yang,Ma Jie,Yang Yunli et al. Relationship between radiation-induced xerostomia and the volume of parotid glands exposed in radiotherapy for nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2018, 27(3): 235-239.
Liu Yang,Ma Jie,Yang Yunli et al. Relationship between radiation-induced xerostomia and the volume of parotid glands exposed in radiotherapy for nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2018, 27(3): 235-239.
[1] Wang XS,Eisbruch A.IMRT for head and neck cancer:reducing xerostomia and dysphagia[J].J Radiat Res,2016,57(Suppl 1):i69.DOI:10.1093/jrr/rrw047. [2] 陈传本,潘建基,陈荔莎,等.IMRT条件下鼻咽癌原发肿瘤体积对预后的影响[J].中华放射肿瘤学杂志,2012,21(3):205-208.DOI:10.3760/cma.j.issn.1004-4221.2012.03.004. Chen CB,Pan JJ,Chen LS,et al. Significance of primary tumor volume on prognosis in nasopharyngeal cardnoma treated by Intensity-modulated radiotherapy[J].Chin J Radiat Oncol,2012,21(3):205-208.DOI:10.3760/cma.j.issn.1004-4221.2012.03.004. [3] 中国鼻咽癌临床分期工作委员会.2010鼻咽癌IMRT靶区及剂量设计指引专家共识[J].中华放射肿瘤学杂志,2011,20(4):267-269.DOI:10.3760/cma.j.issn.1004-4221.2011.04.001.China Clinical Stage Working committee for Nasopharyngeal Carcinoma. The expert consensus of intensity-modulated radiotherapy for nasopharyngeal carcinoma target volume and dose design guidelines in 2010[J].Chin J Radiat Oncol,2011,20(4):267-269.DOI:10.3760/cma.j.issn.1004-4221.2011.04.001. [4] Cox JD,Stetz J,Pajak TF.Toxicity criteria of the radiation therapy oncology group (RTOG) and the European organization for research and treatment of cancer (EORTC)[J].Int J Radiat Oncol Biol Phys,1995,31(5):1341-1346.DOI:10.1016/0360-3016(95)00060-C. [5] Lo KW,To KF,Huang DP.Focus on nasopharyngeal carcinoma[J].Cancer Cell,2004,5(5):423-428.DOI:10.1016/S1535-6108(04)00119-9. [6] Cengiz M zyar E,Esassolak M,et al. Assessment of quality of life of nasopharyngeal carcinoma patients with EORTC QLQ-C30 and H&N-35 modules[J].Int J Radiat Oncol Biol Phys,2005,63(5):1347-1353.DOI:10.1016/j.ijrobp.2005.05.057. [7] Vissink A,Jansma J,Spijkervet FKL,et al. Oral sequelae of head and neck radiotherapy[J].Crit Rev Orall Biol Med,2003,14(3):199.DOI:10.1177/154411130301400305. [8] Vissink A,Burlage FR,Spijkervet FK,et al. Prevention and treatment of the consequences of head and neck radiotherapy.[J].Crit Rev Oral Biol Med,2003,14(3):213.DOI:10.1177/154411130301400306. [9] 徐国增,朱小东.鼻咽癌IMRT唾液腺保护技术应用现状[J].中华放射肿瘤学杂志,2010,19(1):69-71.DOI:10.3760/cma.j.issn.1004-4221.2010.01.026. Xu GZ,Zhu XD.Current status of the application of IMRT to preserve salivary function in nasopharyngeal carcinoma[J].Chin J Radiat Oncol,2010,19(1):69-71.DOI:10.3760/cma.j.issn.1004-4221.2010.01.026. [10] Nishimura Y,Nakamatsu K,Shibata T,et al. Importance of the initial volume of parotid glands in xerostomia for patients with head and neck cancers treated with IMRT[J].Jap J Clin Oncol,2005,35(7):375.DOI:10.1093/jjco/hyi108. [11] 张明霞,孔令玲.鼻咽癌IMRT后近期腮腺功能影响因素分析[J].肿瘤学杂志,2010,16(6):463-466. Zhang MX,Kong LL.Multivariate analysis of the influence factors on the short-term parotid gland function of nasopharyngeal cancer undergoing intensity-modulated radiotherapy[J].J Oncol,2010,16(6):463-466. [12] Eisbruch A,Ten Haken RK,Kim HM,et al. Dose,volume,and function relationships in parotid salivary glands following conformal and intensity-modulated irradiation of head and neck cancer[J].Int J Radiat Oncol BiolPhys,1999,45(3):577.DOI:10.1016/S0360-3016(99)00247-3. [13] Blanco AI,Chao KS,El Naqa I,et al. Dose-volume modeling of salivary function in patients with head-and-neck cancer receiving radiotherapy[J].Int J Radiat Oncol Biol Phys,2005,62(5):1055-1069.DOI:10.1016/j.ijrobp.2004.12.076. [14] Hey J,Setz J,Gerlach R,et al. Parotid gland-recovery after radiotherapy in the head and neck region-36 months follow-up of a prospective clinical study[J].Radiat Oncol,2011,6(1):125.DOI:10.1186/1748-717X-6-125. [15] Kan T,Kodani K,Michimoto K,et al. Radiation-induced damage to microstructure of parotid gland:evaluation using high-resolution magnetic resonance imaging[J].Int J Radiat Oncol Biol Phys,2010,77(4):1030-1038.DOI:10.1016/j.ijrobp.2009.06.010. [16] Nishi T,Nishimura Y,Shibata T,et al. Volume and dosimetric changes and initial clinical experience of a two-step adaptive intensity modulated radiation therapy (IMRT) scheme for head and neck cancer[J].Radiother Oncol,2013,106(1):85-89.DOI:10.1016/j.radonc.2012.11.005. [17] Cozzolino M,Fiorentino A,Oliviero C,et al. Volumetric and dosimetric assessment by cone-beam computed tomography scans in head and neck radiation therapy:a monitoring in four phases of treatment[J].Technol Cancer Res Treat,2014,13(4):325-335.DOI:10.7785/tcrt.2012.500380. [18] Wang X,Lu JX,Zhu G,et al. Anatomic and dosimetric changes during the treatment course of intensity-modulated radiotherapy for locally advanced nasopharyngeal carcinoma[J].Med Dosimet,2010,35(2):151-157.DOI:10.1016/j.meddos.2009.06.007. [19] Marzi S,Pinnarò P,D′Alessio D,et al. Anatomical and dose changes of gross tumour volume and parotid glands for head and neck cancer patients during intensity-modulated radiotherapy:effect on the probability of xerostomia incidence[J].Clin Oncol,2012,24(3):54-62.DOI:10.1016/j.clon.2011.11.006. [20] 曹建忠,罗京伟,徐国镇,等.鼻咽癌IMRT中靶区和正常器官变化规律及临床意义探讨[J].中华放射肿瘤学杂志,2007,16(2):81-85.DOI:10.3760/j.issn:1004-4221.2007.02.001. Cao JZ,Luo JW,Xu GZ,et al. Probe into the clinical significance of target volume and change of the normal organs image-guidedradiotherapy for nasopharyngeal carcinoma[J].Chin J Radiat Oncol,2007,16(2):81-85.DOI:10.3760/j.issn:1004-4221.2007.02.001. [21] 张希梅,曹建忠,罗京伟,等.鼻咽癌IMRT中腮腺体积变化的临床动态研究[J].癌症进展,2009,7(4):431-435.DOI:10.3969/j.issn.1672-1535.2009.04.015. Zhang XM,Cao JZ,Luo JW,et al. Clinical study on variations of parotid volume in intensity modulated radiotherapy for nasopharyngeal carcinoma[J].Oncol Prog,2009,7(4):431-435.DOI:10.3969/j.issn.1672-1535.2009.04.015. [22] Teshima K,Murakami R,Yoshida R,et al. Histopathological changes in parotid and submandibular glands of patients treated with preoperative chemoradiation therapy for oarl cancer[J].J Radiat Res,2012,53(3):492-496.DOI:10.1269/jrr.11115. [23] Eneroth CM,Henrikson CO,Jakobsson PA.Pre-irradiation qualities of a parotid gland predicting the grade of functional disturbance by radiotherapy[J].Acta Oto-laryngol,1972,74(6):436-444. [24] Murdochkinch CA,Kim HM,Vineberg KA,et al. Dose-effect relationships for the submandibular salivary glands and implications for their sparing by intensity modulated radiotherapy[J].Int J Radiat Oncol Biol Phys,2008,72(2):373-382.DOI:10.1016/j.ijrobp.2007.12.033.