Reducing Xerostomia by Comprehensive Protection of Salivary Glands in Intensity-Modulated Radiation Therapy with Helical Tomotherapy Technique for Head-and-Neck Cancer Patients: A Prospective Observational Study

Feng, Teng; Fan, Wenjun; Luo, Yun Mei; Ju, Zhongjian; Gong, Huijie; Ge, Ruigang; Tong, Fang; Zhang, Xinxin; Ma, Lin

doi:10.1155/2019/2401743

Cited by 19 publications

(24 citation statements)

References 25 publications

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“…Although the dose and volume of the PG could be effectively reduced by IMRT technique (4,23,24), other salivary glands were also involved in saliva production. At present, comprehensive protection of salivary glands, including PG, SMG, and OC, has been demonstrated to significantly alleviate xerostomia in patients with HNC treated with HT, without increasing the locoregional recurrence risk (8). Other clinical prognostic factors could affect radiation-induced xerostomia.…”

Section: Discussionmentioning

confidence: 99%

“…Xerostomia was evaluated by a questionnaire and saliva flow rate measurement before RT and at 0, 1, 3, 6, 12, 18, and 24 months after the end of RT. The xerostomia-specific questionnaire was tested and validated (8,18). Saliva flow rates, including unstimulated and stimulated saliva flow rates, were measured as reported in a previous study (8).…”

Section: Treatment and Xerostomia Evaluationmentioning

confidence: 99%

“…Nowadays, IMRT technique, especially helical tomotherapy (HT), provides homogeneous dose distribution in target volumes with a low dose to salivary glands. A previous study reported that comprehensive protection of salivary glands, including parotid glands (PGs), submandibular glands (SMGs), and accessory salivary glands in the oral cavity (OC), minimized xerostomia in patients with head and neck cancer (HNC) treated with HT technique, without increasing early locoregional recurrence risk (8).…”

Section: Introductionmentioning

confidence: 99%

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A Risk Prediction Model by LASSO for Radiation-Induced Xerostomia in Patients With Nasopharyngeal Carcinoma Treated With Comprehensive Salivary Gland–Sparing Helical Tomotherapy Technique

et al. 2021

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ObjectiveThis study aimed to develop a least absolute shrinkage and selection operator (LASSO)-based multivariable normal tissue complication probability (NTCP) model to predict radiation-induced xerostomia in patients with nasopharyngeal carcinoma (NPC) treated with comprehensive salivary gland–sparing helical tomotherapy technique.Methods and MaterialsLASSO with the extended bootstrapping technique was used to build multivariable NTCP models to predict factors of patient-reported xerostomia relieved by 50% and 80% compared with the level at the end of radiation therapy within 1 year and 2 years, R50-1year and R80-2years, in 203 patients with NPC. The model assessment was based on 10-fold cross-validation and the area under the receiver operating characteristic curve (AUC).ResultsThe prediction model by LASSO with 10-fold cross-validation showed that radiation-induced xerostomia recovery could be predicted by prognostic factors of R50-1year (age, gender, T stage, UICC/AJCC stage, parotid Dmean, oral cavity Dmean, and treatment options) and R80-2years (age, gender, T stage, UICC/AJCC stage, oral cavity Dmean, N stage, and treatment options). These prediction models also demonstrated a good performance by the AUC.ConclusionThe prediction models of R50-1year and R80-2years by LASSO with 10-fold cross-validation were recommended to validate the NTCP model before comprehensive salivary gland–sparing radiation therapy in patients with NPC.

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Section: Discussionmentioning

confidence: 99%

Section: Treatment and Xerostomia Evaluationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Risk Prediction Model by LASSO for Radiation-Induced Xerostomia in Patients With Nasopharyngeal Carcinoma Treated With Comprehensive Salivary Gland–Sparing Helical Tomotherapy Technique

et al. 2021

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“…Another unique feature of our study is comparison of ADCs among different degrees of xerostomia graded by patient-rated outcomes at different follow-up timepoints. The questionnaire used in the study was the modified edition of a xerostomia-specific questionnaire which has been validated previously [23,31]. The classification of xerostomia severity based on XQ-sum correlated to the grading system of dry mouth of CTCAE version 5.0 on the whole, with mild, moderate, and severe xerostomia equal to grade 1, 2, and 3 dry mouth by CT-CAE version 5.0, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Before each SFR measurement, patients were asked to complete a modified xerostomia-specific questionnaire which has been validated previously [23]. Briefly, the questionnaire consists of five items regarding dryness when eating, speaking, swallowing, and chewing, and five relating to dryness while at rest.…”

Section: Assessment Of the Degree Of Xerostomiamentioning

confidence: 99%

Diffusion-weighted imaging as a follow-up modality for evaluation of major salivary gland function in nasopharyngeal carcinoma patients: a preliminary study

et al. 2020

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Purpose To investigate the value of diffusion-weighted imaging (DWI) in assessing dynamic changes of major salivary gland function during follow-up post radiotherapy (RT) in nasopharyngeal carcinoma (NPC) patients. Materials and methods 31 consecutive patients with pathologically confirmed NPC scheduled for RT underwent six routine follow-up MRI examinations including DWI sequence prior to (pre-RT) and 1, 3, 6, 9, and 12 months post RT. Mean apparent diffusion coefficient (ADC) values of bilateral parotid glands (PGs) and submandibular glands (SMGs) were measured. Objective measurement of salivary flow rate (SFR) under unstimulated (uSFR) and stimulated conditions (sSFR) as well as subjective xerostomia assessment according to a patient-rated questionnaire were conducted before each MRI. Variance analysis was used to evaluate dynamic changes of ADC, SFR and xerostomia questionnaire summary scores (XQ-sum) at different timepoints and the correlation between ADC and XQ-sum. Pearson's correlation test was used to evaluate the correlations between pre-and post-RT changes of ADC (ΔADC) and SFR (ΔSFR) or mean RT dose. Results At each timepoint, ADCs of PGs were significantly lower than of SMGs, uSFR was significantly lower than sSFR. For both PGs and SMGs, ADCpost-RT were all higher than ADCpre-RT, with significant differences. ADC1m-post-RT initially increased and changed little to ADC3m-post-RT, ADC6m-post-RT, ADC9m-post-RT, and ADC12m-post-RT, then gradually declined over time. The dynamic change trends of SFR were negatively paralleled to those of ADC, while that of XQ-sum was similar. Dose-response relationships were detected between salivary gland mean RT dose and ΔADC. In PGs, negative correlations between ΔsSFR9m-post-RT and ΔADC9m-post-RT, and ΔsSFR12m-post-RT and ΔADC12m-post-RT were detected. In SMGs, negative correlations between ΔsSFR12m-post-RT and ΔADC12m-post-RT, and ΔuSFR12m-post-RT and ΔADC12m-post-RT were also detected. The ADCs of patients with severe subjective xerostomia were significantly higher, while patients with moderate subjective xerostomia presented a tendency toward higher ADCs compared to those with mild xerostomia from 6 to 12 months post RT.

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2024

Clinical Management of Salivary Gland Disorders

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Reducing Xerostomia by Comprehensive Protection of Salivary Glands in Intensity-Modulated Radiation Therapy with Helical Tomotherapy Technique for Head-and-Neck Cancer Patients: A Prospective Observational Study

Cited by 19 publications

References 25 publications

A Risk Prediction Model by LASSO for Radiation-Induced Xerostomia in Patients With Nasopharyngeal Carcinoma Treated With Comprehensive Salivary Gland–Sparing Helical Tomotherapy Technique

A Risk Prediction Model by LASSO for Radiation-Induced Xerostomia in Patients With Nasopharyngeal Carcinoma Treated With Comprehensive Salivary Gland–Sparing Helical Tomotherapy Technique

Diffusion-weighted imaging as a follow-up modality for evaluation of major salivary gland function in nasopharyngeal carcinoma patients: a preliminary study

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