Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Dec 9:3:41.
doi: 10.1186/1748-717X-3-41.

Parotid gland sparing IMRT for head and neck cancer improves xerostomia related quality of life

C M van Rij  1 , W D Oughlane-Heemsbergen, A H Ackerstaff, E A Lamers, A J M Balm, C R N Rasch
Affiliations

Parotid gland sparing IMRT for head and neck cancer improves xerostomia related quality of life

C M van Rij et al. Radiat Oncol. .

Abstract

Background and purpose: To assess the impact of intensity modulated radiotherapy (IMRT) versus conventional radiation on late xerostomia and Quality of Life aspects in head and neck cancer patients. PATIENTS AND NETHODS: Questionnaires on xerostomia in rest and during meals were sent to all patients treated between January 1999 and December 2003 with a T1-4, N0-2 M0 head and neck cancer, with parotid gland sparing IMRT or conventional bilateral neck irradiation to a dose of at least 60 Gy, who were progression free and had no disseminated disease (n = 192). Overall response was 85% (n = 163); 97% in the IMRT group (n = 75) and 77% in the control group (n = 88) the median follow-up was 2.6 years. The prevalence of complaints was compared between the two groups, correcting for all relevant factors at multivariate ordinal regression analysis.

Results: Patients treated with IMRT reported significantly less difficulty transporting and swallowing their food and needed less water for a dry mouth during day, night and meals. They also experienced fewer problems with speech and eating in public. Laryngeal cancer patients in general had fewer complaints than oropharynx cancer patients but both groups benefited from IMRT. Within the IMRT group the xerostomia scores were better for those patients with a mean parotid dose to the "spared" parotid below 26 Gy.

Conclusion: Parotid gland sparing IMRT for head and neck cancer patients improves xerostomia related quality of life compared to conventional radiation both in rest and during meals. Laryngeal cancer patients had fewer complaints but benefited equally compared to oropharyngeal cancer patients from IMRT.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Dose distribution for parotid gland sparing IMRT in Gy, tumor dose 70 Gy. The objective for the parotid gland was set to a mean dose below 26 Gy. A: spared parotid gland, mean dose below 26 Gy, B: sacrified parotid gland, mean dose above 26 Gy.
Figure 2
Figure 2
Multivariate backwards linear regression for the largest subgroups, based on the significant predictive factors for xerostomia during meals (Figure 2A) and in rest (Figure 2B). The score (predicted and actual according the data) for IMRT (black square and open square) as well as Control (black triangle and open triangle) for each defined subgroup with standard error are shown. IV2.5-, interval between radiotherapy and questionnaire (RT-Q) of < 2.5 years, IV2.5+: interval RT-Q > 2.5 years, SU-: no previous surgery, SU+: previous surgery, N0: N0 disease, N2: N2 disease. CT-: no chemotherapy, Ct+: chemotherapy.
See this image and copyright information in PMC

References

    1. Harrison LB, Zelefsky MJ, Pfister DG, Carper E, Raben A, Kraus DH, Strong EW, Rao A, Thaler H, Polyak T, Portenoy R. Detailed quality of life assessment in patients treated with primary radiotherapy for squamous cell cancer of the base of the tongue. Head Neck. 1997;19:169–175. doi: 10.1002/(SICI)1097-0347(199705)19:3<169::AID-HED1>3.0.CO;2-0. - DOI - PubMed
    1. Eisbruch A, Rhodus N, Rosenthal D, Murphy B, Rasch C, Sonis S, Scarantino C, Brizel D. How should we measure and report radiotherapy-induced xerostomia? Semin Radiat Oncol. 2003;13:226–234. doi: 10.1016/S1053-4296(03)00033-X. - DOI - PubMed
    1. Parliament MB, Scrimger RA, Anderson SG, Kurien EC, Thompson HK, Field GC, Hanson J. Preservation of oral health-related quality of life and salivary flow rates after inverse-planned intensity-modulated radiotherapy (IMRT) for head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2004;58:663–673. - PubMed
    1. Malouf JG, Aragon C, Henson BS, Eisbruch A, Ship JA. Influence of parotid-sparing radiotherapy on xerostomia in head and neck cancer patients. Cancer Detect Prev. 2003;27:305–310. doi: 10.1016/S0361-090X(03)00095-3. - DOI - PubMed
    1. Chao KS, Deasy JO, Markman J, Haynie J, Perez CA, Purdy JA, Low DA. A prospective study of salivary function sparing in patients with head-and-neck cancers receiving intensity-modulated or three-dimensional radiation therapy: initial results. Int J Radiat Oncol Biol Phys. 2001;49:907–916. doi: 10.1016/S0360-3016(00)01441-3. - DOI - PubMed