Xerostomia after radiotherapy. What matters--mean total dose or dose to each parotid gland?
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Xerostomia after radiotherapy. What matters--mean total dose or dose to each parotid gland? / Tribius, S; Sommer, J; Prosch, C; Bajrovic, A; Münscher, Adrian; Blessmann, M; Krüll, Andreas; Petersen, Cordula; Todorovic, M; Tennstedt, P.
In: STRAHLENTHER ONKOL, Vol. 189, No. 3, 3, 2013, p. 216-222.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Xerostomia after radiotherapy. What matters--mean total dose or dose to each parotid gland?
AU - Tribius, S
AU - Sommer, J
AU - Prosch, C
AU - Bajrovic, A
AU - Münscher, Adrian
AU - Blessmann, M
AU - Krüll, Andreas
AU - Petersen, Cordula
AU - Todorovic, M
AU - Tennstedt, P
PY - 2013
Y1 - 2013
N2 - PURPOSE: Xerostomia is a debilitating side effect of radiotherapy in patients with head and neck cancer. We undertook a prospective study of the effect on xerostomia and outcomes of sparing one or both parotid glands during radiotherapy for patients with squamous cell carcinoma of the head and neck.METHODS AND MATERIALS: Patients with locally advanced squamous cell carcinoma of the head and neck received definitive (70 Gy in 2 Gy fractions) or adjuvant (60-66 Gy in 2 Gy fractions) curative-intent radiotherapy using helical tomotherapy with concurrent chemotherapy if appropriate. Group A received < 26 Gy to the left and right parotids and group B received < 26 Gy to either parotid.RESULTS: The study included 126 patients; 114 (55 in group A and 59 in group B) had follow-up data. There were no statistically significant differences between groups in disease stage. Xerostomia was significantly reduced in group A vs. group B (p = 0.0381). Patients in group A also had significantly less dysphagia. Relapse-free and overall survival were not compromised in group A: 2-year relapse-free survival was 86% vs. 72% in group B (p = 0.361); 2-year overall survival was 88% and 76%, respectively (p = 0.251).CONCLUSION: This analysis suggests that reducing radiotherapy doses to both parotid glands to < 26 Gy can reduce xerostomia and dysphagia significantly without compromising survival. Sparing both parotids while maintaining target volume coverage and clinical outcome should be the treatment goal and reporting radiotherapy doses delivered to the individual parotids should be standard practice.
AB - PURPOSE: Xerostomia is a debilitating side effect of radiotherapy in patients with head and neck cancer. We undertook a prospective study of the effect on xerostomia and outcomes of sparing one or both parotid glands during radiotherapy for patients with squamous cell carcinoma of the head and neck.METHODS AND MATERIALS: Patients with locally advanced squamous cell carcinoma of the head and neck received definitive (70 Gy in 2 Gy fractions) or adjuvant (60-66 Gy in 2 Gy fractions) curative-intent radiotherapy using helical tomotherapy with concurrent chemotherapy if appropriate. Group A received < 26 Gy to the left and right parotids and group B received < 26 Gy to either parotid.RESULTS: The study included 126 patients; 114 (55 in group A and 59 in group B) had follow-up data. There were no statistically significant differences between groups in disease stage. Xerostomia was significantly reduced in group A vs. group B (p = 0.0381). Patients in group A also had significantly less dysphagia. Relapse-free and overall survival were not compromised in group A: 2-year relapse-free survival was 86% vs. 72% in group B (p = 0.361); 2-year overall survival was 88% and 76%, respectively (p = 0.251).CONCLUSION: This analysis suggests that reducing radiotherapy doses to both parotid glands to < 26 Gy can reduce xerostomia and dysphagia significantly without compromising survival. Sparing both parotids while maintaining target volume coverage and clinical outcome should be the treatment goal and reporting radiotherapy doses delivered to the individual parotids should be standard practice.
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Survival Analysis
KW - Combined Modality Therapy
KW - Retrospective Studies
KW - Dose Fractionation
KW - Radiotherapy Dosage
KW - Neoplasm Staging
KW - Chemotherapy, Adjuvant
KW - Chemoradiotherapy, Adjuvant
KW - Radiotherapy Planning, Computer-Assisted
KW - Carcinoma, Squamous Cell/drug therapy/pathology/radiotherapy/surgery
KW - Otorhinolaryngologic Neoplasms/drug therapy/pathology/radiotherapy/surgery
KW - Parotid Gland/radiation effects
KW - Radiation Injuries/etiology
KW - Radiotherapy, Intensity-Modulated
KW - Xerostomia/etiology
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Survival Analysis
KW - Combined Modality Therapy
KW - Retrospective Studies
KW - Dose Fractionation
KW - Radiotherapy Dosage
KW - Neoplasm Staging
KW - Chemotherapy, Adjuvant
KW - Chemoradiotherapy, Adjuvant
KW - Radiotherapy Planning, Computer-Assisted
KW - Carcinoma, Squamous Cell/drug therapy/pathology/radiotherapy/surgery
KW - Otorhinolaryngologic Neoplasms/drug therapy/pathology/radiotherapy/surgery
KW - Parotid Gland/radiation effects
KW - Radiation Injuries/etiology
KW - Radiotherapy, Intensity-Modulated
KW - Xerostomia/etiology
U2 - 10.1007/s00066-012-0257-2
DO - 10.1007/s00066-012-0257-2
M3 - SCORING: Journal article
C2 - 23354440
VL - 189
SP - 216
EP - 222
JO - STRAHLENTHER ONKOL
JF - STRAHLENTHER ONKOL
SN - 0179-7158
IS - 3
M1 - 3
ER -
