Matthijs H Valstar1, Bernadette S de Bakker2, Roel J H M Steenbakkers3, Kees H de Jong2, Laura A Smit4, Thomas J W Klein Nulent5, Robert J J van Es5, Ingrid Hofland6, Bart de Keizer7, Bas Jasperse8, Alfons J M Balm9, Arjen van der Schaaf3, Johannes A Langendijk3, Ludi E Smeele9, Wouter V Vogel10. 1. Dept. of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute (NCI), Amsterdam, the Netherlands; Dept. of Oral and Maxillofacial Surgery, Amsterdam UMC (AUMC), University of Amsterdam, Amsterdam, the Netherlands. Electronic address: m.valstar@nki.nl. 2. Dept. of Medical Biology, Section Clinical Anatomy & Embryology, AUMC, University of Amsterdam, Amsterdam, the Netherlands. 3. Dept. of Radiation Oncology, University of Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands. 4. Dept. of Pathology, NCI, Amsterdam, the Netherlands. 5. Dept. of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center (UMCU), University Medical Center Utrecht, Utrecht, the Netherlands; Dept. of Oral and Maxillofacial Surgery, UMCU, Utrecht, the Netherlands. 6. Core Facility Molecular Pathology & Biobanking, Division of Pathology, NCI, Amsterdam, the Netherlands. 7. Dept. of Radiology and Nuclear Medicine, UMCU, Utrecht, the Netherlands. 8. Dept. of Radiology, NCI, Amsterdam, the Netherlands. 9. Dept. of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute (NCI), Amsterdam, the Netherlands; Dept. of Oral and Maxillofacial Surgery, Amsterdam UMC (AUMC), University of Amsterdam, Amsterdam, the Netherlands. 10. Dept. of Nuclear Medicine, NCI, Amsterdam, the Netherlands; Dept. of Radiation Oncology, NCI, Amsterdam, the Netherlands.
Abstract
INTRODUCTION: The presence of previously unnoticed bilateral macroscopic salivary gland locations in the human nasopharynx was suspected after visualization by positron emission tomography/computed tomography with prostate-specific membrane antigen ligands (PSMA PET/CT). We aimed to elucidate the characteristics of this unknown entity and its potential clinical implications for radiotherapy. MATERIALS AND METHODS: The presence and configuration of the PSMA-positive area was evaluated in a retrospective cohort of consecutively scanned patients with prostate or urethral gland cancer (n = 100). Morphological and histological characteristics were assessed in a human cadaver study (n = 2). The effect of radiotherapy (RT) on salivation and swallowing was retrospectively investigated using prospectively collected clinical data from a cohort of head-neck cancer patients (n = 723). With multivariable logistic regression analysis, the association between radiotherapy (RT) dose and xerostomia or dysphagia was evaluated. RESULTS: All 100 patients demonstrated a demarcated bilateral PSMA-positive area (average length 4 cm). Histology and 3D reconstruction confirmed the presence of PSMA-expressing, predominantly mucous glands with multiple draining ducts, predominantly near the torus tubarius. In the head-neck cancer patients, the mean RT dose to the gland area was significantly associated with physician-rated post-treatment xerostomia and dysphagia ≥ grade 2 at 12 months (0.019/gy, 95%CI 0.005-0.033, p = .007; 0.016/gy, 95%CI 0.001-0.031, p = .036). Follow-up at 24 months had similar results. CONCLUSION: The human body contains a pair of previously overlooked and clinically relevant macroscopic salivary gland locations, for which we propose the name tubarial glands. Sparing these glands in patients receiving RT may provide an opportunity to improve their quality of life.
INTRODUCTION: The presence of previously unnoticed bilateral macroscopic salivary gland locations in the human nasopharynx was suspected after visualization by positron emission tomography/computed tomography with prostate-specific membrane antigen ligands (PSMA PET/CT). We aimed to elucidate the characteristics of this unknown entity and its potential clinical implications for radiotherapy. MATERIALS AND METHODS: The presence and configuration of the PSMA-positive area was evaluated in a retrospective cohort of consecutively scanned patients with prostate or urethral gland cancer (n = 100). Morphological and histological characteristics were assessed in a human cadaver study (n = 2). The effect of radiotherapy (RT) on salivation and swallowing was retrospectively investigated using prospectively collected clinical data from a cohort of head-neck cancer patients (n = 723). With multivariable logistic regression analysis, the association between radiotherapy (RT) dose and xerostomia or dysphagia was evaluated. RESULTS: All 100 patients demonstrated a demarcated bilateral PSMA-positive area (average length 4 cm). Histology and 3D reconstruction confirmed the presence of PSMA-expressing, predominantly mucous glands with multiple draining ducts, predominantly near the torus tubarius. In the head-neck cancer patients, the mean RT dose to the gland area was significantly associated with physician-rated post-treatment xerostomia and dysphagia ≥ grade 2 at 12 months (0.019/gy, 95%CI 0.005-0.033, p = .007; 0.016/gy, 95%CI 0.001-0.031, p = .036). Follow-up at 24 months had similar results. CONCLUSION: The human body contains a pair of previously overlooked and clinically relevant macroscopic salivary gland locations, for which we propose the name tubarial glands. Sparing these glands in patients receiving RT may provide an opportunity to improve their quality of life.
Authors: V Mohan; N M Bruin; M E T Tesselaar; J P de Boer; E Vegt; J J M A Hendrikx; A Al-Mamgani; J B van de Kamer; J-J Sonke; W V Vogel Journal: EJNMMI Res Date: 2021-03-12 Impact factor: 3.138
Authors: Kimberly J Jasmer; Kristy E Gilman; Kevin Muñoz Forti; Gary A Weisman; Kirsten H Limesand Journal: J Clin Med Date: 2020-12-18 Impact factor: 4.964