Head and Neck Unit, The Royal Marsden NHS Foundation Trust, London, UK.
Radiother Oncol. 2013 Mar;106(3):341-5. doi: 10.1016/j.radonc.2013.03.009. Epub 2013 Apr 6.
To describe the dose-response relationships for the different measures of salivary gland recovery following radical radiotherapy for locally advanced head and neck squamous cell cancers (LA-HNSCC).
Dosimetric analysis of data from the PARSPORT trial, a Phase III study of conventional RT (RT) and intensity modulated radiotherapy (IMRT) for LA-HNSCC was undertaken to determine the relationship between parotid gland mean dose and toxicity endpoints: high-grade subjective and objective xerostomia and xerostomia-related quality of life scores. LKB-NTCP parameters (TD50, m and n) were generated and tolerance doses (D50) reported using non-linear logistic regression analysis.
Data were available on 63 patients from the PARSPORT trial. Parotid saliva flow rate provided the strongest association between mean dose and recovery, D50=23.4 Gy (20.6-26.2) and k=3.2 (1.9-4.5), R(2)=0.85. Corresponding LKB parameters were TD50=26.3 Gy (95% CI: 24.0-30.1), m=0.25 (0.18-1.0 and n=1). LENTSOMA subjective xerostomia also demonstrated a strong association D50=33.3 Gy (26.7-39.8), k=2.8 (91.4-4.4), R(2)=0.77).
We recommend using the LENT SOMA subjective xerostomia score to predict recovery of salivation due to its strong association with dosimetry and ease of recording.
描述放射性治疗局部晚期头颈部鳞癌（LA-HNSCC）后唾液腺恢复的不同指标的剂量反应关系。
对 PARSPORT 试验的数据进行剂量学分析，该试验是一项关于常规放疗（RT）和调强放疗（IMRT）治疗 LA-HNSCC 的 III 期研究，旨在确定腮腺平均剂量与毒性终点之间的关系：高级别的主观和客观口干症以及口干症相关生活质量评分。生成 LKB-NTCP 参数（TD50、m 和 n），并使用非线性逻辑回归分析报告耐受剂量（D50）。
PARSPORT 试验的数据可用于 63 名患者。腮腺唾液流率与恢复之间的关联最强，D50=23.4 Gy（20.6-26.2）和 k=3.2（1.9-4.5），R（2）=0.85。相应的 LKB 参数为 TD50=26.3 Gy（95%CI：24.0-30.1），m=0.25（0.18-1.0）和 n=1。LENTSOMA 主观口干症也表现出强烈的关联，D50=33.3 Gy（26.7-39.8），k=2.8（91.4-4.4），R（2）=0.77。
我们建议使用 LENT SOMA 主观口干症评分来预测唾液分泌的恢复，因为它与剂量学和记录的简便性有很强的关联。
