The effect of concomitant chemotherapy on parotid gland function following head and neck IMRT.
Radiother Oncol
; 106(3): 346-51, 2013 Mar.
Article
em En
| MEDLINE
| ID: mdl-23540553
ABSTRACT
PURPOSE:
To determine whether concomitant chemotherapy increases the incidence of high grade xerostomia following parotid-sparing intensity-modulated radiotherapy (IMRT) in patients with locally advanced head and neck squamous cell cancer. MATERIALS ANDMETHODS:
The incidence of high grade (≥G2) acute (CTCAEv3.0) and late (LENTSOMA and RTOG) xerostomia was compared between patients treated with either IMRT or concomitant chemo-IMRT (c-IMRT) in 2 prospective studies. Parotid gland mean tolerance doses (D50) were reported using non-linear logistic regression analysis.RESULTS:
Thirty-six patients received IMRT alone and 60 patients received c-IMRT. Patients received 65 Gy in 30 daily fractions to the primary site and involved nodal groups and 54 Gy in 30 fractions to elective nodal groups, mean doses to the parotid glands were comparable. Concomitant cisplatin 100mg/m(2) was administered on days 1 and 29 of IMRT. The incidence of ≥G2 subjective xerostomia was similar in both groups; acute-64.7% (IMRT) versus 60.3% (c-IMRT), p=0.83; late-43% (IMRT) versus 34% (c-IMRT), p=0.51. Recovery of parotid salivary flow at 1 year was higher with IMRT (64% vs 50%), but not statistically significant (p=0.15). D50 for absence of parotid saliva flow at 1 year was 23.2 Gy (95% CI 17.7-28.7) for IMRT and 21.1 Gy (11.8-30.3) for c-IMRT.CONCLUSION:
Concomitant c-IMRT does not increase the incidence of acute or late xerostomia relative to IMRT alone.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Glândula Parótida
/
Carcinoma de Células Escamosas
/
Radioterapia de Intensidade Modulada
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Quimiorradioterapia
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Neoplasias de Cabeça e Pescoço
Tipo de estudo:
Incidence_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
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Humans
/
Male
Idioma:
En
Revista:
Radiother Oncol
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Reino Unido
País de publicação:
IE
/
IRELAND
/
IRLANDA