Jianzhong Cao1, Xiaodong Zhang2, Bo Jiang3, Jiayun Chen3, Xiaochun Wang3, Li Wang4, Narayan Sahoo3, X Ronald Zhu3, Rong Ye5, Pierre Blanchard6, Adam S Garden7, C David Fuller7, G Brandon Gunn7, Steven J Frank8. 1. Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States; Department of Radiation Oncology, The Shanxi Cancer Hospital and Institute, Affiliated Hospital of Shanxi Medical University, Shanxi, China. 2. Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, United States. Electronic address: xizhang@mdanderson.org. 3. Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, United States. 4. Experimental Radiation Oncology, and The University of Texas MD Anderson Cancer Center, Houston, United States. 5. Quantitative Sciences, The University of Texas MD Anderson Cancer Center, Houston, United States. 6. Department of Radiotherapy, Gustave Roussy Cancer Campus, Villejuif, France. 7. Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States. 8. Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States. Electronic address: sjfrank@mdanderson.org.
Abstract
BACKGROUND AND PURPOSE: To determine rates of xerostomia after intensity-modulated radiotherapy (IMRT) or intensity-modulated proton therapy (IMPT) for oropharyngeal cancer (OPC) and identify dosimetric factors associated with xerostomia risk. MATERIALS AND METHODS: Patients with OPC who received IMRT (n = 429) or IMPT (n = 103) from January 2011 through June 2015 at a single institution were studied retrospectively. Every 3 months after treatment, each patient completed an eight-item self-reported xerostomia-specific questionnaire (XQ; summary XQ score, 0-100). An XQ score of 50 was selected as the demarcation value for moderate-severe (XQs ≥ 50) and no-mild (XQs < 50) xerostomia. The mean doses and percent volumes of organs at risk receiving various doses (V5-V70) were extracted from the initial treatment plans. The dosimetric variables and xerostomia risk were compared using an independent-sample t-test or chi-square test. RESULTS: The median follow-up time was 36.2 months. The proportions of patients with moderate-severe xerostomia were similar in the two treatment groups up to 18 months after treatment. However, moderate-severe xerostomia was less common in the IMPT group than in the IMRT group at 18-24 months (6% vs. 20%; p = 0.025) and 24-36 months (6% vs. 20%; p = 0.01). During the late xerostomia period (24-36 months), high dose/volume exposures (V25-V70) in the oral cavity were associated with high proportions of patients with moderate-severe xerostomia (all p < 0.05), but dosimetric variables regarding the salivary glands were not associated with late xerostomia. CONCLUSION: IMPT was associated with less late xerostomia than was IMRT in OPC patients. Oral cavity dosimetric variables were related to the occurrence of late xerostomia.
BACKGROUND AND PURPOSE: To determine rates of xerostomia after intensity-modulated radiotherapy (IMRT) or intensity-modulated proton therapy (IMPT) for oropharyngeal cancer (OPC) and identify dosimetric factors associated with xerostomia risk. MATERIALS AND METHODS: Patients with OPC who received IMRT (n = 429) or IMPT (n = 103) from January 2011 through June 2015 at a single institution were studied retrospectively. Every 3 months after treatment, each patient completed an eight-item self-reported xerostomia-specific questionnaire (XQ; summary XQ score, 0-100). An XQ score of 50 was selected as the demarcation value for moderate-severe (XQs ≥ 50) and no-mild (XQs < 50) xerostomia. The mean doses and percent volumes of organs at risk receiving various doses (V5-V70) were extracted from the initial treatment plans. The dosimetric variables and xerostomia risk were compared using an independent-sample t-test or chi-square test. RESULTS: The median follow-up time was 36.2 months. The proportions of patients with moderate-severe xerostomia were similar in the two treatment groups up to 18 months after treatment. However, moderate-severe xerostomia was less common in the IMPT group than in the IMRT group at 18-24 months (6% vs. 20%; p = 0.025) and 24-36 months (6% vs. 20%; p = 0.01). During the late xerostomia period (24-36 months), high dose/volume exposures (V25-V70) in the oral cavity were associated with high proportions of patients with moderate-severe xerostomia (all p < 0.05), but dosimetric variables regarding the salivary glands were not associated with late xerostomia. CONCLUSION: IMPT was associated with less late xerostomia than was IMRT in OPC patients. Oral cavity dosimetric variables were related to the occurrence of late xerostomia.
Authors: Nancy Y Lee; Fernando F de Arruda; Dev R Puri; Suzanne L Wolden; Ashwatha Narayana; James Mechalakos; Ennapadam S Venkatraman; Dennis Kraus; Ashok Shaha; Jatin P Shah; David G Pfister; Michael J Zelefsky Journal: Int J Radiat Oncol Biol Phys Date: 2006-11-15 Impact factor: 7.038
Authors: Sébastien Clavel; David H A Nguyen; Bernard Fortin; Philippe Després; Nader Khaouam; David Donath; Denis Soulières; Louis Guertin; Phuc Felix Nguyen-Tan Journal: Int J Radiat Oncol Biol Phys Date: 2011-02-01 Impact factor: 7.038
Authors: Angel I Blanco; K S Clifford Chao; Issam El Naqa; Gregg E Franklin; Konstantin Zakarian; Milos Vicic; Joseph O Deasy Journal: Int J Radiat Oncol Biol Phys Date: 2005-07-15 Impact factor: 7.038
Authors: Charles B Simone; David Ly; Tu D Dan; John Ondos; Holly Ning; Arnaud Belard; John O'Connell; Robert W Miller; Nicole L Simone Journal: Radiother Oncol Date: 2011-06-12 Impact factor: 6.280
Authors: Adepitan A Owosho; Maria Thor; Jung Hun Oh; Nadeem Riaz; C Jillian Tsai; Haley Rosenberg; Spyridon Varthis; Sae Hee K Yom; Joseph M Huryn; Nancy Y Lee; Joseph O Deasy; Cherry L Estilo Journal: J Craniomaxillofac Surg Date: 2017-01-31 Impact factor: 2.078
Authors: Anke Petra Jellema; Ben J Slotman; Patricia Doornaert; C René Leemans; Johannes A Langendijk Journal: Int J Radiat Oncol Biol Phys Date: 2007-06-08 Impact factor: 7.038
Authors: Pètra M Braam; Judith M Roesink; Cornelis P J Raaijmakers; Wim B Busschers; Chris H J Terhaard Journal: Radiat Oncol Date: 2007-01-05 Impact factor: 3.481