The effect of concomitant chemotherapy on parotid gland function following head and neck IMRT.
Date
2013-03-26Author
Miah, AB
Gulliford, SL
Bhide, SA
Zaidi, SH
Newbold, KL
Harrington, KJ
Nutting, CM
Type
Journal Article
Metadata
Show full item recordAbstract
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 and methods 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.
Collections
Subject
Parotid Gland
Humans
Carcinoma, Squamous Cell
Head and Neck Neoplasms
Xerostomia
Incidence
Adult
Aged
Aged, 80 and over
Female
Male
Radiotherapy, Intensity-Modulated
Chemoradiotherapy
Squamous Cell Carcinoma of Head and Neck
Research team
Radiotherapy Physics Modelling
Targeted Therapy
Language
eng
Date accepted
2013-03-04
License start date
2013-03-26
Citation
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2013, 106 (3), pp. 346 - 351