Xerostomia in patients treated for oropharyngeal carcinoma: Comparing linear accelerator-based intensity-modulated radiation therapy with helical tomotherapy

作者：Fortin Israel^*; Fortin Bernard; Lambert Louise; Clavel Sebastien; Alizadeh Moein; Filion Edith J; Soulieres Denis; Belair Manon; Guertin Louis; Phuc Felix Nguyen Tan

来源：Head and Neck-Journal for the Sciences and Specialties of the Head and Neck, 2014, 36(9): 1343-1348.

DOI：10.1002/hed.23463

• xerostomia
• quantitative analysis of normal tissue effects in the clinic (QUANTEC)
• helical tomotherapy
• oropharyngeal carcinoma
• parotid glands

Background. In comparison to sliding-window intensity-modulated radiation therapy (sw-IMRT), we hypothesized that helical tomotherapy (HT) would achieve similar locoregional control and, at the same time, decrease the parotid gland dose, thus leading to a xerostomia reduction.
Methods. The association between radiation techniques, mean parotid dose, and xerostomia incidence, was reviewed in 119 patients with advanced oropharyngeal carcinoma treated with concurrent chemoradiation using sw-IMRT (n = 59) or HT (n = 60).
Results. Ipsilateral and contralateral parotid mean doses were significantly lower for patients treated with HT versus sw-IMRT: 24 Gy versus 32 Gy ipsilaterally and 20 Gy versus 25 Gy contralaterally. The incidence of grade >= 2 xerostomia was significantly lower in the HT group than in the sw-IMRT group: 12% versus 78% at 6 months, 3% versus 51% at 12 months, and 0% versus 25% at 24 months. Total parotid mean dose <25 Gy was strongly associated to a lower incidence of grade >= 2 xerostomia at 6, 12, and 24 months.
Conclusion. This retrospective series suggests that using HT can better spare the parotid glands while respecting quantitative analysis of normal tissue effects in the clinic (QUANTEC)'s criteria.

• 出版日期2014-9