QUALITY OF LIFE IN HEAD AND NECK CANCER

申请人的描述（Applicant's Description） 晚期头颈部恶性肿瘤的标准放疗通常会导致 永久性口腔干燥，被患者引用为减少 生活质量 为了减少辐射引起的口干症，我们 已经开始研究保留大唾液腺的可行性 组织，同时充分照射患者的目标， 全面的双侧颈部照射 为此，我们利用 基于计算机断层扫描的适形三维（3D）放射计划 和治疗工具。 我们已达到足够的目标覆盖率， 腮腺组织明显保留。 大量唾液流 保存已经实现。 这项工作的目标是提高 辐射后的长期生活质量。 我们的目标是在拟议的 研究旨在评估生活质量改善的程度， 使用这些技术治疗的患者与类似患者相比 用标准技术治疗，以评估是否改善 口干症和生活质量与唾液流量有关 保持辐射后，并确定之间的关系， 照射的体积和输送到腮腺的剂量及其 辐射后的功能。 结果将确立方法论 进行随机化，更大的试验，需要测试 我们使用的技术在多大程度上改善了生活质量 同时与标准技术相比保持肿瘤控制率， 以确定是否值得进行此类试验。

DESCRIPTION (Applicant's Description) Standard radiation for advanced head and neck malignancies typically causes permanent xerostomia that is cited by patients as a major cause of reduced quality of life. In an effort to reduce radiation-induced xerostomia, we have initiated a study of the feasibility of sparing major salivary gland tissue while adequately irradiating the targets in patients requiring comprehensive, bilateral neck irradiation. For this purpose, we utilize computed-tomography based conformal, 3-dimensional (3D) radiation planning and treatment tools. We have achieved adequate target coverage and significant sparing of parotid gland tissue. Significant saliva flow preservation has been achieved. The goal of this work is to improve long-term quality of life following radiation. Our aims in the proposed study are to assess the extent of improvement in the quality of life in patients treated using these techniques compared with s i milar patients treated with standard techniques, to assess whether improvements in xerostomia and quality of life are related to the amount of saliva flow retained following radiation, and to determine the relationships between the volumes irradiated and the doses delivered to the parotid glands and their function following radiation. The results will establish the methodology for conducting randomized, larger trials that are required to test the extent to which the techniques we have utilized improve quality of life while preserving tumor control rates compared with standard techniques, and to determine if such trials are worth undertaking.