PURPOSE: The aim of this study was to compare changes in salivary gland function after intensity-modulated radiotherapy (IMRT) and conventional radiotherapy (RT), with or without Amifostine, for tumors of the head-and-neck region using quantitative salivary gland scintigraphy (QSGS). METHODS AND MATERIALS: A total of 75 patients received pre- and post-therapeutic QSGS to quantify the salivary gland function. In all, 251 salivary glands were independently evaluated. Changes in the maximum uptake (DeltaU) and relative excretion rate (DeltaF) both pre- and post-RT were determined to characterize radiation-induced changes in the salivary gland function. In addition, dose-response curves were calculated. RESULTS: In all groups, maximum uptake and relative excretion rate were reduced after RT (DeltaU <or=0 and DeltaF <or=0). The reduction was significantly lower for IMRT than for conventional RT. For the parotid glands, the reduction was smaller for the IMRT-low than for the IMRT-high group. For the Amifostine-high and the conventional group the difference was significant only for one parameter (DeltaU, parotid and submandibular glands, p < 0.05). In contrast to this, the difference between the Amifostine-low and the conventional group was always significant or at least showed a clear trend for both changes in U and F. In regard to the endpoint "reduction of the salivary gland excretion rate of more than 50%," the dose-response curves yielded D50-values of 34.2 +/- 12.2 Gy for the conventionally treated group and 36.8 +/- 2.9 Gy for the IMRT group. For the Amifostine group, an increased D50-values of 46.3 +/- 2.3 Gy was obtained. CONCLUSION: Intensity-modulated RT can significantly reduce the loss of parotid gland function when respecting a certain dose threshold. Conventional RT plus Amifostine prevents reduced salivary gland function only in the patient group treated with <40.6 Gy.
PURPOSE: The aim of this study was to compare changes in salivary gland function after intensity-modulated radiotherapy (IMRT) and conventional radiotherapy (RT), with or without Amifostine, for tumors of the head-and-neck region using quantitative salivary gland scintigraphy (QSGS). METHODS AND MATERIALS: A total of 75 patients received pre- and post-therapeutic QSGS to quantify the salivary gland function. In all, 251 salivary glands were independently evaluated. Changes in the maximum uptake (DeltaU) and relative excretion rate (DeltaF) both pre- and post-RT were determined to characterize radiation-induced changes in the salivary gland function. In addition, dose-response curves were calculated. RESULTS: In all groups, maximum uptake and relative excretion rate were reduced after RT (DeltaU <or=0 and DeltaF <or=0). The reduction was significantly lower for IMRT than for conventional RT. For the parotid glands, the reduction was smaller for the IMRT-low than for the IMRT-high group. For the Amifostine-high and the conventional group the difference was significant only for one parameter (DeltaU, parotid and submandibular glands, p < 0.05). In contrast to this, the difference between the Amifostine-low and the conventional group was always significant or at least showed a clear trend for both changes in U and F. In regard to the endpoint "reduction of the salivary gland excretion rate of more than 50%," the dose-response curves yielded D50-values of 34.2 +/- 12.2 Gy for the conventionally treated group and 36.8 +/- 2.9 Gy for the IMRT group. For the Amifostine group, an increased D50-values of 46.3 +/- 2.3 Gy was obtained. CONCLUSION: Intensity-modulated RT can significantly reduce the loss of parotid gland function when respecting a certain dose threshold. Conventional RT plus Amifostine prevents reduced salivary gland function only in the patient group treated with <40.6 Gy.
Authors: Joseph O Deasy; Vitali Moiseenko; Lawrence Marks; K S Clifford Chao; Jiho Nam; Avraham Eisbruch Journal: Int J Radiat Oncol Biol Phys Date: 2010-03-01 Impact factor: 7.038
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Authors: Vitali Moiseenko; Jonn Wu; Allan Hovan; Ziad Saleh; Aditya Apte; Joseph O Deasy; Stephen Harrow; Carman Rabuka; Adam Muggli; Anna Thompson Journal: Int J Radiat Oncol Biol Phys Date: 2011-06-02 Impact factor: 7.038