A PROSPECTIVE STUDY OF SALIVARY GLAND FUNCTION IN LYMPHOMA PATIENTS RECEIVING HEAD AND NECK IRRADIATION

作者：Rodrigues Neesha A; Killion Leah; Hickey Gail; Silver Barbara; Martin Chrystalla; Stevenson Mary Ann; Mauch Peter M; Ng Andrea K^*

来源：International Journal of Radiation Oncology, Biology, Physics, 2009, 75(4): 1079-1083.

DOI：10.1016/j.ijrobp.2008.12.053

• Lymphoma
• Head and neck
• Quality of Life
• Xerostomia
• Amifostine

Purpose: To determine the radiation dose-response relationship on salivary dysfunction and quality of life (QOL) over time in patients With lymphoma receiving radiation therapy (RT) to the head and neck (H&N).
Methods and Materials: We conducted a prospective study on salivary-gland function in lymphoma patients jeceiving RT to the H&N. Fifteen patients were enrolled on the study. Dose-volume histograms and mean doses to the salivary glands were generated. Radiation-related toxicities and H&N-specific QOL were assessed before treatment and at prespecified time points posttreatment. Factors predicting a decrement in QOL were explored using Fisher's exact test.
Results: During RT, 47% of patients experienced Grade >= 2 acute toxicity of the salivary gland, mucous membrane, or both. QOL scores improved over time, but up to one third of patients continued to have persistent oral symptoms at 2 years. At 6 months, a mean dose to at least one of the parotids of > 31 Gy was significantly associated with persistent dry mouth (100% vs. 17%, p = 0.02) and sticky saliva (100% vs. 25 %, p = 0.04); a mean dose of > I I Gy to the minor salivary glands was significantly associated with persistent sticky saliva (100% vs. 25 %, p = 0.04), although the difference was no longer significant at 1 year.
Conclusions: Limiting the mean parotid dose to <= 31 Gy and mean minor salivary gland dose to <= 11 Gy in lymphoma patients treated to the H&N may help reduce the risk of subacute xerostomia.

• 出版日期2009-11-15