Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, and Chang Gung University, College of Medicine, Tao-yuan, Taiwan.
Oral Oncol. 2013 Jan;49(1):42-8. doi: 10.1016/j.oraloncology.2012.07.004. Epub 2012 Jul 31.
We investigated salivary function using quantitative scintigraphy and sought to identify functional correlations between parotid dose and quality of life (QoL) for head and neck cancer (HNC) patients receiving intensity-modulated radiotherapy (IMRT).
Between August, 2007 and June, 2008, 31 patients treated IMRT for HNC were enrolled in this prospective study. Salivary excretion function (SEF) was previously measured by salivary scintigraphy at annual intervals for 2 years after IMRT. A dose-volume histogram of each parotid gland was calculated, and the normal tissue complication probability (NTCP) was used to determine the tolerance dose. QoL was longitudinally assessed by the EORTC QLQ-C30 and H&N35 questionnaires prior to RT, and at one, three, 12 and 24 months after RT.
A significant correlation was found between the reduction of SEF and the mean parotid dose measured at 1 year (correlation coefficient, R(2)=0.651) and 2 years (R(2)=0.310) after IMRT (p<0.001). The TD(50) of the parotid gland at 1 year after IMRT is 43.6 Gy, comparable to results from western countries. We further found that contralateral parotid and submandibular gland function preservation was correlated with reduced sticky saliva and a better QoL compared to the functional preservation of both parotid glands, as determined by the EORTC QLQ-H&N35 questionnaire.
A significant correlation was found between the reduction of SEF and the mean parotid dose. Preservation of contralateral parotid and submandibular gland function predicts a better QoL compared to preservation of the function of both parotid glands.
我们通过定量闪烁扫描来研究唾液功能，并试图确定头颈部癌症（HNC）患者接受调强放疗（IMRT）后腮腺剂量与生活质量（QoL）之间的功能相关性。
2007 年 8 月至 2008 年 6 月期间，我们纳入了 31 例接受 IMRT 治疗的 HNC 患者，对其进行前瞻性研究。在 IMRT 后 2 年内，每年通过唾液闪烁扫描测量唾液排泄功能（SEF）。计算每个腮腺的剂量-体积直方图，并使用正常组织并发症概率（NTCP）来确定耐受剂量。在放疗前、放疗后 1、3、12 和 24 个月，使用 EORTC QLQ-C30 和 H&N35 问卷对 QoL 进行纵向评估。
在 IMRT 后 1 年（相关系数 R(2)=0.651）和 2 年（R(2)=0.310）时，SEF 的降低与腮腺的平均剂量呈显著相关性（p<0.001）。IMRT 后 1 年时腮腺的 TD(50)为 43.6Gy，与西方国家的结果相当。我们进一步发现，与双侧腮腺功能保存相比，对侧腮腺和颌下腺功能保存与粘唾液减少和 QoL 改善相关，这可通过 EORTC QLQ-H&N35 问卷来确定。
SEF 的降低与腮腺的平均剂量呈显著相关性。与双侧腮腺功能保存相比，对侧腮腺和颌下腺功能保存可预测更好的 QoL。
