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Xerostomia after radiotherapy : What matters-mean total dose or dose to each parotid gland?
MedLine Citation:
PMID:  23354440     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
S Tribius; J Sommer; C Prosch; A Bajrovic; A Muenscher; M Blessmann; A Kruell; C Petersen; M Todorovic; P Tennstedt
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-27
Journal Detail:
Title:  Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]     Volume:  -     ISSN:  1439-099X     ISO Abbreviation:  Strahlenther Onkol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8603469     Medline TA:  Strahlenther Onkol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany, tribius@uke.uni-hamburg.de.
Vernacular Title:
Xerostomie nach Strahlentherapie : Was ist klinisch relevant - die durchschnittliche Gesamtdosis oder die Dosis in jeder Parotis?
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