Scintigraphic assessment of early and late parotid gland function after radiotherapy for head-and-neck cancer: A prospective study of dose-volume response relationships
Scintigraphic assessment of early and late parotid gland function after radiotherapy for head-and-neck cancer: A prospective study of dose-volume response relationships
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DOI：
10.1016/j.ijrobp.2003.09.021
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发表时间：
2004-04-01
影响因子：
7
通讯作者：
Terhaard, CHJ
中科院分区：
文献类型：
--
作者：
Roesink, JM;Moerland, MA;Terhaard, CHJ
目的：探讨腮腺功能的间接测量放射治疗（RT）后的腮腺造影术的价值。方法和材料：96例原发性或术后RT的各种恶性肿瘤在头颈部进行了前瞻性评价。分别于放疗前、放疗后6周和1年行腮腺造影，计算治疗前后腮腺对唾液的摄取率、唾液向口腔的排泄率（SEF）及摄取率与SEF的比值。基于CT的治疗计划被用来获得腮腺的剂量-体积直方图。为了建立辐射剂量和腮腺体积的影响，将莱曼提出的正常组织并发症概率模型拟合到数据中。192个腮腺的平均最大摄取从RT前的3329个计数（ct）-/s显著下降到3084个ct/s和3005个ct/s。治疗前SEF为44.7%。放疗后6周，SEF下降至18.7%，但放疗后1年，SEF恢复至32.4%。放疗后1年的摄取与腮腺平均剂量之间存在显著相关性。RT后SEF的降低与平均腮腺剂量显著相关。正常组织并发症概率模型参数TD 50在放疗后6周和1年分别为29和43戈伊，并发症定义为治疗后SEF腮腺比率为
Purpose: To investigate the value of scintigraphy as an indirect measurement of parotid function after radiotherapy (RT).Methods and Materials: Ninety-six patients with primary or postoperative RT for various malignancies in the head-and-neck region were prospectively evaluated. Parotid gland scintigraphy was performed before RT and 6 weeks and 1 year after RT. The uptake, excretion fraction of the saliva from the parotid gland to the oral cavity (SEF), and the ratios of uptake and SEF after and before treatment were calculated. CT-based treatment planning was used to derive dose-volume histograms of the parotid glands. To establish the effects of both the radiation dose and the volume of the parotid gland irradiated, the normal tissue complication probability model proposed by Lyman was fit to the data.Results: The mean maximal uptake of 192 parotid glands decreased significantly from 3329 counts (ct)-/s before RT to 3084 ct/s and 3005 ct/s at 6 weeks and 1 year after RT. The SEF before treatment was 44.7%. The SEF decreased to 18.7% at 6 weeks after RT, but recovered to a SEF of 32.4% at 1 year after RT. A significant correlation was found between the uptake 1 year after RT and the mean parotid dose. The reduction in post-RT SEF correlated significantly with the mean parotid gland dose. The normal tissue complication probability model parameter TD50 was found to be 29 and 43 Gy at 6 weeks and 1 year after RT, respectively, when a complication was defined as a posttreatment SEF parotid ratio of