Ortholan C, Benezery K, Bensadoun R-J
Service de Radiothérapie, Centre Antoine-Lacassagne, 33 Avenue Valombrose, 06189 Nice cedex 2, France.
Cancer Radiother. 2010 Jul;14(4-5):290-4. doi: 10.1016/j.canrad.2010.03.007. Epub 2010 Jul 6.
Xerostomia is one of the most a common complication of radiotherapy for head and neck cancers, affecting quality of life. Parotid glands produce approximately 60% of saliva and submandibular glands 20% of saliva while the rest is secreted by sublingual and accessory salivary glands. Methods of measuring the salivary output are collection of unstimulated or stimulated saliva or 99mTc-pertechnate scintigraphy. Several studies demonstrated that late salivary dysfunction after radiotherapy has been correlated to the mean parotid gland dose, with recovery occurring with time. Severe xerostomia could be avoided if at one parotid gland is spared to a mean dose of less than approximately 25-30 Gy. Clinical benefit of submandibular gland sparing is more controversial. A mean dose less than 39 Gy could preserve submandibular gland function. This paper aims to review main studies evaluating tolerance dose of salivary glands.
口干症是头颈部癌症放射治疗最常见的并发症之一，会影响生活质量。腮腺分泌约60%的唾液，颌下腺分泌20%的唾液，其余由舌下腺和附属唾液腺分泌。测量唾液分泌量的方法有收集非刺激性或刺激性唾液，或进行99mTc-高锝酸盐闪烁扫描。多项研究表明，放疗后晚期唾液功能障碍与腮腺平均剂量相关，且会随时间恢复。如果一侧腮腺的平均剂量低于约25-30 Gy，可避免严重口干症。保留颌下腺的临床益处更具争议性。平均剂量低于39 Gy可保留颌下腺功能。本文旨在综述评估唾液腺耐受剂量的主要研究。
