Evaluation of salivary gland function after treatment of head-and-neck tumors with intensity-modulated radiotherapy by quantitative pertechnetate scintigraphy

Münter, Marc W.; Karger, Christian P.; Hoffner, Simone; Hof, Holger; Thilmann, Christoph; Rudat, Volker; Nill, Simeon; Wannenmacher, M; Debus, Jürgen

doi:10.1016/s0360-3016(03)01437-8

Cited by 139 publications

(80 citation statements)

References 29 publications

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“…Fox et al, in a double-blind, placebo-controlled study of 39 patients with post-irradiation �erostomia, found 94.8% of the subjects to e�perience improvement after one month of treatment with 5 mg of pilocarpine three times a day -this improvement being maintained for 6 months after the end of radiotherapy (21). Many studies have shown that intensity-modulated radiotherapy contributes to improve salivary gland preservation (17,(22)(23)(24)(25). Dysgeusia induced by radiotherapy is conditioned by a series of factors: direct neuroto�ic action upon the taste receptor cells, �erostomia and possible overinfections.…”

Section: Discussionmentioning

confidence: 99%

Dental implications in oral cancer patients

et al. 2011

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Objectives. A study is made of the dental implications of oral cancer, with a view to avoiding the complications that appear once oncological treatment is started. Patients and Methods. The study comprised a total of 22 patients diagnosed with oral cancer according to clinical and histological criteria in the Service of Ma�illofacial Surgery (Dental Clinic of the University of Barcelona, Spain) during the period 1996-2005, and posteriorly treated in different hospital centers in Barcelona. Results. Of the 22 patients diagnosed with oral cancer in our Service, the present study finally analyzed the 12 subjects who reported for the dental controls. As regards the remaining 10 patients, 5 had died and 5 could not be located; these subjects were thus e�cluded from the analysis. All of the smokers had abandoned the habit. The most common tumor location was the lateral margin of the tongue. None of the patients visited the dentist regularly before the diagnosis of oral cancer. T1N0M0 was the most common tumor stage. Surgery was carried out in 50% of the cases, while 8.4% of the patients received radiotherapy and 41.6% underwent surgery with postoperative radiotherapy. In turn, 66.6% of the patients reported treatment sequelae such as dysgeusia, �erostomia or speech difficulties, and one patient suffered osteoradionecrosis. Forty-one percent of the patients did not undergo regular dental controls after cancer treatment. As regards oral and dental health, 16.6% presented caries, and 50% had active periodontal disease. Conclusions. Protocols are available for preventing the complications of oral cancer treatment, and thus for improving patient quality of life. However, important shortcomings in the application of such protocols on the part of the public health authorities make it difficult to reach these objectives.

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Section: Discussionmentioning

confidence: 99%

Dental implications in oral cancer patients

et al. 2011

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“…This finding motivates reducing the doses to the salivary glands to as low levels as possible. Data on dose response in the parotid glands are accumulating [10,[52][53][54][55]. The common finding with all these data is that a relationship seems to exist between the mean doses to the glands and their residual salivary output.…”

Section: Less Normal Tissue Morbidity With Imrtmentioning

confidence: 94%

Intensity-Modulated Radiation Therapy for Head and Neck Carcinoma

et al. 2007

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After completing this course, the reader will be able to:1. Outline innovations related to targeted radiation therapy.2. Describe trials proving an advantage using IMRT.3. Assess treatment planning modalities and how IMRT fields are designed.4. Evaluate when there is a toxicity advantage for IMRT.5. Discern when conventional radiotherapy should be used instead of IMRT.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACT Intensity-modulated radiation therapy (IMRT) for head and neck tumors refers to a new approach that aims at increasing the radiation dose gradient between the target tissues and the surrounding normal tissues at risk, thus offering the prospect of increasing the locoregional control probability while decreasing the complication rate. As a prerequisite, IMRT requires a proper selection and delineation of target volumes. For the latter, recent data indicate the potential of functional imaging to complement anatomic imaging modalities. Nonrandomized clinical series in paranasal sinuses and pharyngolaryngeal carcinoma have shown that IMRT was able to achieve a very high rate of locoregional control with less morbidity, such as dry-eye syndrome, xerostomia, and swallowing dysfunction. The promising results of IMRT are likely to be achieved when many treatment conditions are met, for example, optimal selection and delineation of the target volumes and organs at risk, appropriate physical quality control of the irradiation, and accurate patient setup with the use of onboard imaging. Because of the complexity of the various tasks, it is thus likely that these conditions will only be

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“…The loss of salivary gland function can reduce the quality of life and may lead to impairment of social activities for long-term survivors (1). Several patients who receive radiation in cancer therapy may complain about numerous side effects including xerostomia, dysphagia, taste changes, high dental caries risk, difficulty in swallowing and speaking (2).…”

Section: Introductionmentioning

confidence: 99%

Radioprotective Effect of Vitamin E in Parotid Glands: a Morphometric Analysis in Rats

et al. 2013

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The aim of this study was to evaluate the radioprotective effect of vitamin E on rat parotid glands by morphometric analysis. Sixty male rats were divided into 5 groups (n=6): control, in which animals received olive oil solution; olive oil/irradiated, in which animals received olive oil and were irradiated with a dose of 15 Gy of gamma radiation; irradiated, in which animals were irradiated with a dose of 15 Gy gamma radiation; vitamin E, which received α-tocopherol acetate solution; vitamin E/irradiated, which received α-tocopherol acetate solution before irradiation with a dose of 15 Gy gamma rays. Half of the animals were euthanized at 8 h, and the remaining at 30 days after irradiation. Both parotid glands were surgically removed and morphometric analysis of acinar cells was performed. Data were subjected to two-way ANOVA and Tukey's test (α=0.05). Morphometric analysis showed a significant reduction in the number of parotid acinar cells at 30 days in olive oil/irradiated and irradiated groups. In groups evaluated over time a significant reduction was shown at 30 days in olive oil/irradiated and irradiated groups, indicating that ionizing radiation caused tissue damage. The vitamin E/irradiated group presented more acinar cells than the irradiated group, but no statistically significant difference was observed (p>0.05). In conclusion, vitamin E seems to have failed as a radioprotective agent on acinar cells in rat parotid glands. R a d i o p r o t e c t i v e E f f e c t o f V i t a m i n E i n Pa r o t i d G l a n d s :

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Evaluation of salivary gland function after treatment of head-and-neck tumors with intensity-modulated radiotherapy by quantitative pertechnetate scintigraphy

Cited by 139 publications

References 29 publications

Dental implications in oral cancer patients

Dental implications in oral cancer patients

Intensity-Modulated Radiation Therapy for Head and Neck Carcinoma

Radioprotective Effect of Vitamin E in Parotid Glands: a Morphometric Analysis in Rats

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