Dose-response relationships within the parotid gland after radiotherapy for head and neck cancer
Dose-response relationships within the parotid gland after radiotherapy for head and neck cancer
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DOI：
10.1016/j.radonc.2004.09.015
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发表时间：
2004-12-01
影响因子：
5.7
通讯作者：
Van den Bogaert, W
中科院分区：
文献类型：
--
作者：
Bussels, B;Maes, A;Van den Bogaert, W
背景和目的：为了确定唾液腺功能，腮腺保留放疗（RT）后，腮腺内的不同区域，并评估腮腺内和patients.Patients和方法之间的剂量-功能关系：16头和颈部癌症患者，照射1999年9月至2000年11月之间使用适形腮腺保留技术。被纳入本研究。放疗前及放疗后7个月（6-10个月）行腮腺造影，并结合单光子发射型计算机断层扫描（SPECT），于刺激后测量每个腮腺的8-12个5转横断面SPECT切片的唾液分泌分数（SEF）。这些切片的唾液排泄分数损失（dSEF %）计算为RT后SEF与RT前SEF的比例。由于计划CT扫描和SPECT扫描在相同的治疗位置进行，腮腺内横向切片的剂量可以与相应切片的唾液分泌分数的损失相匹配。计算功能丧失数据和导致唾液排泄分数损失50%的剂量（D-50）。结果：RT前，除一名患者外，所有患者双侧腮腺的唾液排泄分数（SEF）均正常。在同一个腮腺里。不同切片的SEF几乎相等。RT后7个月，SEF的降低具有统计学意义（P值
Background and purpose: To determine the salivary function, after parotid-sparing radiotherapy (RT), of different regions within the parotid gland and to evaluate dose-function relationships within the parotid glands and between patients.Patients and methods: Sixteen head and neck cancer patients, irradiated between September 1999 and November 2000 using a conformal parotid-sparing technique. were included in this study. Before RT and 7 months after RT (range 6-10 months), a salivary gland scintigraphy was performed in all patients combined with a single photon emission computed tomography (SPECT).The salivary excretion fraction (SEF) was measured, after stimulation, in 8-12 transverse 5 turn SPECT slices of each parotid. Loss of salivary excretion fraction (dSEF %) of these slices was calculated as the proportion of SEF after RT as compared to SEF before RT.Since the planning CT-scan and the SPECT-scintigraphy were per-formed in the same treatment position, the dose to a transverse slice within the parotid gland could be matched to the loss of salivary excretion fraction of that respective slice.A non-linear model was fitted to the dose-loss of function data and the dose resulting in 50% loss of salivary excretion fraction (D-50) was calculated.Results: Before RT. all but one patient presented with normal salivary excretion fractions (SEF) of both parotid glands. Within the same parotid gland. the SEF's of the different slices were almost equal.Seven months after RT the reduction in SEF was statistically significant (P-value