The role of parotid gland irradiation in the development of severe hyposalivation (xerostomia) after intensity-modulated radiation therapy for head and neck cancer: Temporal patterns, risk factors, and testing the QUANTEC guidelines

Owosho, Adepitan A.; Thor, Maria; Oh, Jung Hun; Riaz, Nadeem; Tsai, C. Jillian; Rosenberg, Haley I.; Varthis, Spyridon; Yom, Sue S.; Huryn, Joseph M.; Lee, Nancy Y.; Deasy, Joseph O.; Estilo, Cherry L.

doi:10.1016/j.jcms.2017.01.020

Cited by 24 publications

(16 citation statements)

References 35 publications

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“…Radiation dose to the salivary glands has been widely studied for the risk of xerostomia. Mean dose to the whole ipsilateral/contralateral parotid gland (iPG, cPG) affects xerostomia incidence, but not the recovery of saliva function 11,12 . In terms of RT-induced salivary gland dysfunction, the radiosensitivity of the PG is not homogeneous 13–17 .…”

Section: Introductionmentioning

confidence: 99%

Dose/Volume histogram patterns in Salivary Gland subvolumes influence xerostomia injury and recovery

Han

Lakshminarayanan

Jiang

et al. 2019

Sci Rep

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Xerostomia is a common consequence of radiotherapy in head and neck cancer. The objective was to compare the regional radiation dose distribution in patients that developed xerostomia within 6 months of radiotherapy and those recovered from xerostomia within 18 months post-radiotherapy. We developed a feature generation pipeline to extract dose volume histogram features from geometrically defined ipsilateral/contralateral parotid glands, submandibular glands, and oral cavity surrogates for each patient. Permutation tests with multiple comparisons were performed to assess the dose difference between injury vs. non-injury and recovery vs. non-recovery. Ridge logistic regression models were applied to predict injury and recovery using clinical features along with dose features (D10-D90) of the subvolumes extracted from oral cavity and salivary gland contours + 3 mm peripheral shell. Model performances were assessed by the area under the receiver operating characteristic curve (AUC) using nested cross-validation. We found that different regional dose/volume metrics patterns exist for injury vs. recovery. Compared to injury, recovery has increased importance to the subvolumes receiving lower dose. Within the subvolumes, injury tends to have increased importance towards D10 from D90. This suggests that different threshold for xerostomia injury and recovery. Injury is induced by the subvolumes receiving higher dose, and the ability to recover can be preserved by further reducing the dose to subvolumes receiving lower dose.

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Section: Introductionmentioning

confidence: 99%

Dose/Volume histogram patterns in Salivary Gland subvolumes influence xerostomia injury and recovery

Han

Lakshminarayanan

Jiang

et al. 2019

Sci Rep

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“…Dose to PAGs is important in terms of xerostomia, because they produce up to 70% of the total stimulated saliva. 20 , 21 , 22 , 23 Owosho et al . analyzed the role of PAGs irradiation in the development of severe xerostomia defined as Grade 4 according to the LENT SOMA scales after IMRT, and reported that xerostomia occurred in a follow-up time of <6 months, when the Dmean to iPAG and cPAG was 43.8 Gy and 24.9 Gy, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…analyzed the role of PAGs irradiation in the development of severe xerostomia defined as Grade 4 according to the LENT SOMA scales after IMRT, and reported that xerostomia occurred in a follow-up time of <6 months, when the Dmean to iPAG and cPAG was 43.8 Gy and 24.9 Gy, respectively. 23 They concluded that the incidence of xerostomia could be decreased by limiting the mean dose to both PAGs to values below 25 Gy. In our study the mean doses to iPAG and cPAG were 4.6% (3.2 Gy) and 3.9% (2.7 Gy) with VMAT and 4.6% (2.1 Gy) and 3.0% (1.4 Gy) with IGBT, respectively.…”

Section: Discussionmentioning

confidence: 99%

Image guided high-dose-rate brachytherapy versus volumetric modulated arc therapy for head and neck cancer: A comparative analysis of dosimetry for target volume and organs at risk

Akiyama

Pesznyák

Béla

et al. 2018

Radiology and Oncology

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BackgroundThe aim of the study was to present dosimetric comparison of image guided high-dose-rate brachytherapy (IGBT) with volumetric modulated arc therapy (VMAT) for head and neck cancer regarding conformity of dose distribution to planning target volume (PTV) and doses to organs at risk (OARs).Patients and methodsThirty-eight consecutive patients with T1-4 mobile tongue, floor of mouth and base of tongue cancer treated with IGBT were selected. For these patients additional VMAT treatment plans were also prepared using identical computed tomography data. OARs and PTV related parameters (e.g. V98, D0.1cm3, Dmean, etc.) were compared.ResultsMean V98 of the PTV was 90.2% vs. 90.4% (p > 0.05) for IGBT and VMAT, respectively. Mean D0.1cm3 to the mandible was 77.0% vs. 85.4% (p < 0.05). Dmean to ipsilateral and contralateral parotid glands was 4.6% vs. 4.6% and 3.0% vs. 3.9% (p > 0.05). Dmean to ipsilateral and contralateral submandibular glands was 16.4% vs. 21.9% (p > 0.05) and 8.2% vs. 16.9% (p < 0.05), respectively.ConclusionsBoth techniques showed excellent target coverage. With IGBT dose to normal tissues was lower than with VMAT. The results prove the superiority of IGBT in the protection of OARs and the important role of this invasive method in the era of new external beam techniques.

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“…Morfologicamente, as glândulas salivares tornam-se menores e sofrem alteração em sua densidade com o passar do tempo (124) .…”

Section: Xerostomia E Toxicidade Mucosaunclassified

“…É controverso na literatura se a adição de quimioterapia à IMRT aumenta a incidência de xerostomia em relação ao tratamento com IMRT isolada (124,128) .…”

Section: Xerostomia E Toxicidade Mucosaunclassified

Avaliação de toxicidades tardias em pacientes com carcinoma epidermoide de cabeça e pescoço submetidos a quimiorradiação concomitante baseada em cisplatina

Rivelli¹

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The role of parotid gland irradiation in the development of severe hyposalivation (xerostomia) after intensity-modulated radiation therapy for head and neck cancer: Temporal patterns, risk factors, and testing the QUANTEC guidelines

Cited by 24 publications

References 35 publications

Dose/Volume histogram patterns in Salivary Gland subvolumes influence xerostomia injury and recovery

Dose/Volume histogram patterns in Salivary Gland subvolumes influence xerostomia injury and recovery

Image guided high-dose-rate brachytherapy versus volumetric modulated arc therapy for head and neck cancer: A comparative analysis of dosimetry for target volume and organs at risk

Avaliação de toxicidades tardias em pacientes com carcinoma epidermoide de cabeça e pescoço submetidos a quimiorradiação concomitante baseada em cisplatina

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