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Identifying dose constraints for the parotid ducts to minimize patient-reported xerostomia: Is conventional mean dose sparing of the parotid glands sufficient?
Ahmidouch, Manal; Das, Shiva K; Zhu, Tong; Shen, Colette; Marks, Lawrence B; Chera, Bhishamjit S; Fried, David V.
Afiliación
  • Ahmidouch M; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
  • Das SK; Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
  • Zhu T; Department of Radiation Oncology, Washington University at St. Louis, St. Louis, Missouri, USA.
  • Shen C; Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
  • Marks LB; Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
  • Chera BS; Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina, USA.
  • Fried DV; Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
J Appl Clin Med Phys ; : e14515, 2024 Sep 17.
Article en En | MEDLINE | ID: mdl-39288256
ABSTRACT
BACKGROUND AND

PURPOSE:

The aim of this study was to identify dose constraints for the parotid ducts that limit patient-reported xerostomia and estimate whether these constraints are achieved during conventional parotid gland sparing radiation therapy (PGS-RT). METHODS AND MATERIALS Thirty-eight oropharyngeal squamous cell carcinoma patients were treated prospectively on trial with MRI sialography-guided parotid duct sparing radiation therapy (PDS-RT). PDS-RT explicitly minimizes dose to the parotid ducts in addition to PGS-RT. Parotid duct dose constraints were identified that distinguished patients reporting high and low rates of xerostomia. Atlas-based parotid duct contours were generated on a retrospective cohort of similar patients where the parotid ducts were not contoured nor explicitly spared to estimate the dose received by the parotid ducts during PGS-RT.

RESULTS:

Patients whose intraglandular parotid ducts or total parotid ducts were planned for a mean dose < 14 Gy and < 12 Gy, respectively, reported significantly (p < 0.01) lower rates of xerostomia at 6 and 12 months post-RT. Patients receiving PDS-RT had average total and intraglandular duct doses of 11.6  and 13.6 Gy, respectively, compared to an estimated 23.8  and 22.1 Gy, for those receiving PGS-RT (p < 0.01). Only 6% (6/108) and 20% (22/108) of patients receiving PGS-RT were estimated to meet the dose constraints for the total ducts and intraglandular ducts, respectively.

CONCLUSION:

Parotid duct dose thresholds exist that appear to distinguish patients with and without xerostomia. The identified dose thresholds are frequently not met in PGS-RT plans. In addition to reducing the dose to the parotid gland(s), parotid duct sparing may also further reduce xerostomia.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Appl Clin Med Phys Asunto de la revista: BIOFISICA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Appl Clin Med Phys Asunto de la revista: BIOFISICA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos