Dose-volume modeling of salivary function in patients with head-and-neck cancer receiving radiotherapy.

摘要: Purpose: We investigated the factors that affect salivary function after head-and-neck radiotherapy (RT), including parotid gland dose-volume effects, potential compensation by less-irradiated tissue, and functional recovery over time. Methods Materials: Sixty-five patients with tumors were enrolled in a prospective study. RT was delivered using intensity-modulated ( n = 45), forward-planning three-dimensional conformal 14), or an boost 6). Whole flow measured before therapy at 6 months 61) 12 31) RT. A wide variety of models to predict post-RT tested. Xerostomia defined according subjective, objective, management, analytic (SOMA) criteria as occurring when posttreatment Results: significant correlation observed between relative quality-of-life scores stimulated saliva values (Spearman's coefficient [R s ] 0.46, p (−A × mean dose), equal 0.054/Gy (68% confidence interval 0.052–0.059), provided good representation data incorporated into our multimetric analysis. Using model, we estimated dose 25.8 Gy, on average, likely reduce single gland's 25% its pretreatment value, regardless treatment delivery method. Significant correlations logistic multivariate model (incorporating dose-exponential equation, gender, Karnofsky performance status) (R 0.73), 0.54), score 0.35) Conclusion: Stimulated strongly correlated both The rates improved from Salivary function, each gland, appeared be lost exponentially rate approximately 5%/1 Gy dose. Additional research is necessary distinguish among for use planning. incidence xerostomia significantly decreased least one kept