Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3 Suppl):S58-63. doi: 10.1016/j.ijrobp.2009.06.090.
Publications relating parotid dose-volume characteristics to radiotherapy-induced salivary toxicity were reviewed. Late salivary dysfunction has been correlated to the mean parotid gland dose, with recovery occurring with time. Severe xerostomia (defined as long-term salivary function of <25% of baseline) is usually avoided if at least one parotid gland is spared to a mean dose of less than approximately 20 Gy or if both glands are spared to less than approximately 25 Gy (mean dose). For complex, partial-volume RT patterns (e.g., intensity-modulated radiotherapy), each parotid mean dose should be kept as low as possible, consistent with the desired clinical target volume coverage. A lower parotid mean dose usually results in better function. Submandibular gland sparing also significantly decreases the risk of xerostomia. The currently available predictive models are imprecise, and additional study is required to identify more accurate models of xerostomia risk.
回顾了与放疗引起的唾液毒性相关的腮腺剂量-体积特征的出版物。晚期唾液功能障碍与腮腺平均剂量相关，随着时间的推移会逐渐恢复。如果至少一侧腮腺的平均剂量小于约 20Gy，或者如果两侧腮腺的平均剂量均小于约 25Gy（平均剂量），则可以避免严重的口干（定义为长期唾液功能<基线的 25%）。对于复杂的部分容积 RT 模式（例如强度调制放疗），应尽可能保持每个腮腺的平均剂量较低，同时保证期望的临床靶区覆盖。较低的腮腺平均剂量通常会导致更好的功能。颌下腺的保留也显著降低了口干的风险。目前可用的预测模型不够精确，需要进一步研究以确定更准确的口干风险模型。
