Department of Radiology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan.
Jpn J Clin Oncol. 2011 Apr;41(4):503-7. doi: 10.1093/jjco/hyq236. Epub 2011 Jan 12.
To evaluate longitudinal changes in parotid volumes and saliva production over 2 years after 30 Gy irradiation.
We retrospectively evaluated 15 assessable patients treated for advanced oral cancer. Eligibility criteria were a pathologic diagnosis of squamous cell carcinoma, preoperative radiation therapy with a total dose of 30 Gy delivered in 15 fractions, and the availability of longitudinal data of morphological assessments by computed tomography and functional assessments with the Saxon test spanning 2 years after radiation therapy. In the Saxon test, saliva production was measured by weighing a folded sterile gauze pad before and after chewing; the low-normal value is 2 g/2 min. Repeated-measures analysis of variance with Bonferroni adjustment for multiple comparisons was used to determine the longitudinal changes.
The normalized ipsilateral parotid volumes 2 weeks and 6-, 12- and 24 months after radiation therapy were found to be 72.5, 63.7, 66.9 and 78.1%, respectively; the normalized contralateral volumes were 69.8, 64.6, 72.2 and 82.0%, respectively. The bilateral parotid volumes were significantly decreased after radiation therapy (P < 0.01). The nadir appeared at 6 months post-radiation therapy and the volumes substantially recuperated 24 months after radiation therapy (P < 0.01). Mean saliva production before radiation therapy was 3.7 g; the longitudinal changes after radiation therapy were 31.3, 38.0, 43.3 and 69.6%, respectively. Substantial recuperation of saliva production was observed 24 months after radiation therapy (P = 0.01).
Although parotid volumes and saliva production were decreased after 30 Gy irradiation, we observed the recuperation of morphological and functional changes in the parotid glands 2 years after radiation therapy.
评估 30Gy 放疗后 2 年内腮腺体积和唾液分泌的纵向变化。
我们回顾性评估了 15 例可评估的晚期口腔癌患者。入选标准为病理诊断为鳞状细胞癌、术前放疗总剂量为 30Gy，分 15 次给予，以及在放疗后 2 年内有形态学评估的纵向 CT 数据和萨克森测试的功能评估数据。在萨克森测试中，通过称重折叠无菌纱布垫前后来测量唾液分泌量；低正常值为 2g/2min。采用重复测量方差分析和 Bonferroni 多重比较调整，确定纵向变化。
放疗后 2 周、6 个月、12 个月和 24 个月时，同侧腮腺体积的归一化值分别为 72.5%、63.7%、66.9%和 78.1%；对侧体积的归一化值分别为 69.8%、64.6%、72.2%和 82.0%。放疗后双侧腮腺体积明显减少（P<0.01）。最低点出现在放疗后 6 个月，放疗后 24 个月体积明显恢复（P<0.01）。放疗前平均唾液产量为 3.7g；放疗后 6 个月、8 个月、12 个月和 24 个月的纵向变化分别为 31.3%、38.0%、43.3%和 69.6%。放疗后 24 个月观察到唾液产生的显著恢复（P=0.01）。
虽然腮腺体积和唾液分泌在 30Gy 照射后减少，但我们观察到腮腺形态和功能变化在放疗后 2 年内得到恢复。
