Parotid gland-recovery after radiotherapy in the head and neck region - 36 months follow-up of a prospective clinical study

摘要

Background The aim of the present study was to evaluate the recovery potential of the parotid glands after using either 3D-conformal-radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) by sparing one single parotid gland. Methods Between 06/2002 and 10/2008, 117 patients with head and neck cancer were included in this prospective, non-randomised clinical study. All patients were treated with curative intent. Salivary gland function was assessed by measuring stimulated salivary flow at the beginning, during and at the end of radiotherapy as well as 1, 6, 12, 24, and 36 months after treatment. Measurements were converted to flow rates and normalized relative to rates before treatment. Mean doses (D_mean) were calculated from dose-volume histograms based on computed tomographies of the parotid glands. Results Patients were grouped according to the D_mean of the spared parotid gland having the lowest radiation exposure: Group I - D_mean mean 26-40 Gy (n = 45), and group III - D_mean mean of the spared parotid gland could be significantly reduced (D_mean IMRT vs. 3D-CRT: 21.7 vs. 34.4 Gy, p Conclusions If a D_mean mean of the parotids, and thus on the saliva flow and recovery of parotid gland.