The impact of dose on parotid salivary recovery in head and neck cancer patients treated with radiation therapy
The impact of dose on parotid salivary recovery in head and neck cancer patients treated with radiation therapy
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DOI：
10.1016/j.ijrobp.2006.09.021
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发表时间：
2007-03-01
影响因子：
7
通讯作者：
Eisbruch, Avraham
中科院分区：
文献类型：
--
作者：
Li, Yun;Taylor, Jeremy M. G.;Eisbruch, Avraham
目的：头颈部癌症患者在放射治疗（RT）后经历的常见副作用是腮腺产生唾液的能力受损。我们的目的是探讨放射剂量和唾液的变化之间的关系，在2年后treatment.Methods和Materials：研究人群包括142例接受适形或调强放疗。在治疗前和治疗后1、3、6、12、18和24个月测量266个腮腺的唾液流速。在刺激和未刺激条件下分别从每个腺体收集测量值。贝叶斯非线性层次模型的开发和拟合的data.Results：腮腺接受较高的辐射产生较少的唾液。RT后1-3个月降低幅度最大，随后逐渐恢复。当平均剂量较低时（例如，< 25戈伊），模型预测的平均刺激唾液在12个月时恢复到治疗前水平，并在18和24个月时超过治疗前水平。对于更高剂量（例如，>戈伊），刺激唾液在2年后不恢复到原始水平。在没有刺激的情况下，在24个月时，预测的唾液是25戈伊和40戈伊治疗前水平的86%< 31% for >。我们没有发现证据支持，刺激唾液在18和24个月后，在一个腮腺低剂量的过度生产是低唾液生产的结果，从其他paradygland.Conclusions：唾液生产受到辐射显着影响，但与剂量< 25-30戈伊，恢复是实质性的，并返回到治疗前的水平2年后RT。
Purpose: A common side effect experienced by head and neck cancer patients after radiation therapy (RT) is impairment of the parotid glands' ability to produce saliva. Our purpose is to investigate the relationship between radiation dose and saliva changes in the 2 years after treatment.Methods and Materials: The study population includes 142 patients treated with conformal or intensity-modulated radiotherapy. Saliva flow rates from 266 parotid glands are measured before and 1, 3, 6, 12, 18, and 24 months after treatment. Measurements are collected separately from each gland under both stimulated and unstimulated conditions. Bayesian nonlinear hierarchical models were developed and fit to the data.Results: Parotids receiving higher radiation produce less saliva. The largest reduction is at 1-3 months after RT followed by gradual recovery. When mean doses are lower (e.g., < 25 Gy), the model-predicted average stimulated saliva recovers to pretreatment levels at 12 months and exceeds it at 18 and 24 months. For higher doses (e.g., > 30 Gy), the stimulated saliva does not return to original levels after 2 years. Without stimulation, at 24 months, the predicted saliva is 86% of pretreatment levels for 25 Gy and < 31% for > 40 Gy. We do not find evidence to support that the overproduction of stimulated saliva at 18 and 24 months after low dose in 1 parotid gland is the result of low saliva production from the other parotid gland.Conclusions: Saliva production is affected significantly by radiation, but with doses < 25-30 Gy, recovery is substantial and returns to pretreatment levels 2 years after RT. (c) 2007 Elsevier Inc.