Dose-response analysis of parotid gland function: What is the best measure of xerostomia?

作者：Miah Aisha B; Gulliford Sarah L; Clark Catharine H; Bhide Shreerang A; Zaidi Shane H; Newbold Kate L; Harrington Kevin J; Nutting Christopher M^*

来源：Radiotherapy and Oncology, 2013, 106(3): 341-345.

DOI：10.1016/j.radonc.2013.03.009

• Head and Neck Cancers
• Radiotherapy
• IMRT
• Xerostomia
• Parotid gland

Purpose: To describe the dose-response relationships for the different measures of salivary gland recovery following radical radiotherapy for locally advanced-head and neck squamous cell cancers (LA-HNSCC).
Methods and materials: Dosimetric analysis of data from the PARSPORT trial, a Phase III study of conventional RT (RT) and intensity modulated radiotherapy (IMRT) for LA-HNSCC was undertaken to determine the relationship between parotid gland mean dose and toxicity endpoints: high-grade subjective and objective xerostomia and xerostomia-related quality of life scores. LKB-NTCP parameters (TD50, m and n) were generated and tolerance doses (D50) reported using non-linear logistic regression analysis.
Results: Data were available on 63 patients from the PARSPORT trial. Parotid saliva flow rate provided the strongest association between mean dose and recovery, D50 = 23.4 Gy (20.6-26.2) and k = 3.2 (1.9-4.5), R-2 = 0.85. Corresponding LKB parameters were TD50 = 26.3 Gy (95% CI: 24.0-30.1), m = 0.25 (0.18-1.0 and n = 1). LENTSOMA subjective xerostomia also demonstrated a strong association D50 = 33.3 Gy (26.7-39.8), k = 2.8 (91.4-4.4), R-2 = 0.77).
Conclusion: We recommend using the LENT SOMA subjective xerostomia score to predict recovery of salivation due to its strong association with dosimetry and ease of recording.

• 出版日期2013-3