Intensity-modulated radiotherapy significantly reduces xerostomia compared with conventional radiotherapy |
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Authors: | Braam Pètra M Terhaard Chris H J Roesink Judith M Raaijmakers Cornelis P J |
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Affiliation: | Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands. P.M.Braam@umcutrecht.nl |
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Abstract: | PURPOSE: Xerostomia is a severe complication after radiotherapy for oropharyngeal cancer, as the salivary glands are in close proximity with the primary tumor. Intensity-modulated radiotherapy (IMRT) offers theoretical advantages for normal tissue sparing. A Phase II study was conducted to determine the value of IMRT for salivary output preservation compared with conventional radiotherapy (CRT). METHODS AND MATERIALS: A total of 56 patients with oropharyngeal cancer were prospectively evaluated. Of these, 30 patients were treated with IMRT and 26 with CRT. Stimulated parotid salivary flow was measured before, 6 weeks, and 6 months after treatment. A complication was defined as a stimulated parotid flow rate <25% of the preradiotherapy flow rate. RESULTS: The mean dose to the parotid glands was 48.1 Gy (SD 14 Gy) for CRT and 33.7 Gy (SD 10 Gy) for IMRT (p < 0.005). The mean parotid flow ratio 6 weeks and 6 months after treatment was respectively 41% and 64% for IMRT and respectively 11% and 18% for CRT. As a result, 6 weeks after treatment, the number of parotid flow complications was significantly lower after IMRT (55%) than after CRT (87%) (p = 0.002). The number of complications 6 months after treatment was 56% for IMRT and 81% for CRT (p = 0.04). CONCLUSIONS: IMRT significantly reduces the number of parotid flow complications for patients with oropharyngeal cancer. |
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Keywords: | Intensity-modulated radiotherapy Xerostomia Parotid gland Oropharynx Head-and-neck cancer |
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