Treatment planning constraints to avoid xerostomia in head-and-neck radiotherapy: an independent test of QUANTEC criteria using a prospectively collected dataset.
Treatment planning constraints to avoid xerostomia in head-and-neck radiotherapy: an independent test of QUANTEC criteria using a prospectively collected dataset.
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DOI：
10.1016/j.ijrobp.2011.04.020
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发表时间：
2012-03-01
影响因子：
7
通讯作者：
Thompson, Anna
中科院分区：
文献类型：
--
作者：
Moiseenko, Vitali;Wu, Jonn;Hovan, Allan;Saleh, Ziad;Apte, Aditya;Deasy, Joseph O.;Harrow, Stephen;Rabuka, Carman;Muggli, Adam;Thompson, Anna
唾液腺功能的严重降低（口干症）是头颈部癌症放射治疗后常见的并发症。因此，QUANTEC小组和Ortholan等人提出了基于腮腺耐受剂量体积参数确保充分功能的指南。我们对前瞻性收集的数据集进行了这些指南的验证测试，并与以前发表的数据集进行了比较。测量了66例在不列颠哥伦比亚省癌症机构（BCCA）接受放射治疗的头颈部癌症患者的全口刺激唾液流数据，并提取了治疗计划数据。在3个月和12个月随访时分别收集了50例患者和60例患者的血流测量值。先前发表的数据从第二个机构（WUSTL）用于比较。使用逻辑模型描述4级口干症的发生率作为备用腮腺平均剂量的函数。计算QUANTEC限制和Ortholan等人建议的正确预测无口干症的比率（阴性预测值，NPV），以将接受超过40戈伊的两个腺体的总体积限制为小于33%。两个数据集均显示，当最低辐照腮腺的平均剂量保持在20戈伊以下时，口干症发生率<20%。基于最少照射腺体，治疗后12个月口干症发生率的Logistic模型参数为D50=32.4戈伊和γ=0.97。QUANTEC指南的NPV为94%（BCCA数据），90%（WUSTL数据）。对于Ortholan等人，指南NPV为85%（BCCA）和86%（WUSTL）。这证实了QUANTEC指南有效避免了口干症，并且这在某种程度上比限制接受超过40戈伊的体积更有效。
The severe reduction of salivary function (xerostomia) is a common complication following radiation therapy for head and neck cancer. Consequently, guidelines to ensure adequate function based on parotid gland tolerance dose-volume parameters have been suggested by the QUANTEC group and by Ortholan et al.. We perform a validation test of these guidelines against a prospectively collected dataset and compared to a previously published dataset. Whole-mouth stimulated salivary flow data from 66 head and neck cancer patients treated with radiotherapy at the British Columbia Cancer Agency (BCCA) were measured, and treatment planning data were abstracted. Flow measurements were collected from 50 patients at 3 months, and 60 patients at 12 month follow-up. Previously published data from a second institution (WUSTL) were used for comparison. A logistic model was used to describe the incidence of grade 4 xerostomia as a function of the mean dose of the spared parotid gland. The rate of correctly predicting the lack of xerostomia (negative predictive value, NPV) was computed for both the QUANTEC constraints and Ortholan et al. recommendation to constrain the total volume of both glands receiving more than 40 Gy to less than 33%. Both data sets showed a rate of xerostomia < 20 % when the mean dose to the least-irradiated parotid gland is kept below 20 Gy. Logistic model parameters for the incidence of xerostomia at 12 months after therapy, based on the least-irradiated gland, were D50=32.4 Gy and and γ=0.97. NPVs for QUANTEC guideline were 94% (BCCA data), 90% (WUSTL data). For Ortholan et al. guideline NPVs were 85% (BCCA), and 86% (WUSTL). This confirms that the QUANTEC guideline effectively avoids xerostomia, and this is somewhat more effective than constraints on the volume receiving more than 40 Gy.
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干细胞移植在辐照腺体中的干细胞移植后拯救唾液腺功能。
影响因子：
3.7
作者：
Lombaert, Isabelle M. A.;Brunsting, Jeanette F.;Wierenga, Pieter K.;Faber, Hette;Stokman, Monique A.;Kok, Tineke;Visser, Willy H.;Kampinga, Harm H.;de Haan, Gerald;Coppes, Robert P.
通讯作者：
Coppes, Robert P.
影响因子：
3.8
作者：
Deasy, JO;Blanco, AI;Clark, VH
通讯作者：
Clark, VH
影响因子：
3.4
作者：
Bhide, S. A.;Miah, A. B.;Nutting, C. M.
通讯作者：
Nutting, C. M.
DOI：
10.1016/s0360-3016(99)00460-5
发表时间：
2000-01-01
影响因子：
7
作者：
Jha, N;Seikaly, H;Coulter, L
通讯作者：
Coulter, L
影响因子：
5.7
作者：
ROBERTS, SA;HENDRY, JH
通讯作者：
HENDRY, JH