Sparing the region of the salivary gland containing stem cells preserves saliva production after radiotherapy for head and neck cancer.
Sparing the region of the salivary gland containing stem cells preserves saliva production after radiotherapy for head and neck cancer.
复制标题
DOI：
10.1126/scitranslmed.aac4441
复制
发表时间：
2015-09-16
影响因子：
17.1
通讯作者：
Coppes RP
中科院分区：
文献类型：
--
作者：
van Luijk P;Pringle S;Deasy JO;Moiseenko VV;Faber H;Hovan A;Baanstra M;van der Laan HP;Kierkels RG;van der Schaaf A;Witjes MJ;Schippers JM;Brandenburg S;Langendijk JA;Wu J;Coppes RP
每年有50万头颈癌患者接受放射治疗，生存率相对较高。然而，在40%的患者中，由于辐射引起的唾液腺功能损害和随之而来的口干，生活质量严重受损。新的放射治疗技术可以保留部分唾液腺。我们已经确定了主要唾液腺的部分，腮腺，需要保留，以确保腺体在放射治疗后继续产生唾液。在小鼠、大鼠和人类中，我们发现干细胞和祖细胞存在于腮腺包含主要导管的区域。我们在大鼠身上证明，在辐射场中包括导管会导致再生能力的丧失，导致长期的腺体功能障碍和唾液分泌减少。然后，我们在一组头颈癌患者中显示，唾液腺中含有干细胞/祖细胞的区域的辐射剂量预测了放射治疗一年后唾液腺的功能。最后，我们发现在放疗期间唾液腺的这一区域可以被保留，从而降低了放疗后口干的风险。
Each year, 500,000 patients are treated with radiotherapy for head and neck cancer, resulting in relatively high survival rates. However, in 40% of patients, quality of life is severely compromised because of radiation-induced impairment of salivary gland function and consequent xerostomia (dry mouth). New radiation treatment technologies enable sparing of parts of the salivary glands. We have determined the parts of the major salivary gland, the parotid gland, that need to be spared to ensure that the gland continues to produce saliva after irradiation treatment. In mice, rats, and humans, we showed that stem and progenitor cells reside in the region of the parotid gland containing the major ducts. We demonstrated in rats that inclusion of the ducts in the radiation field led to loss of regenerative capacity, resulting in long-term gland dysfunction with reduced saliva production. Then we showed in a cohort of patients with head and neck cancer that the radiation dose to the region of the salivary gland containing the stem/progenitor cells predicted the function of the salivary glands one year after radiotherapy. Finally, we showed that this region of the salivary gland could be spared during radiotherapy, thus reducing the risk of post-radiotherapy xerostomia.