Divisions of Otolaryngology - Head and Neck Surgery, Departments of Surgery, University of Alberta, Edmonton, Alberta, Canada.
West Virginia University, Morgantown, West Virginia, U.S.A.
Laryngoscope. 2020 Apr;130(4):925-929. doi: 10.1002/lary.28039. Epub 2019 May 14.
Treatment for advanced head and neck cancers typically includes surgery followed by radiation therapy (RT). Radiation-induced xerostomia is a common sequela of these treatments. The modified submandibular gland transfer (M-SGT) procedure was developed to decrease xerostomia in the treatment of oral cavity cancer by sparing one submandibular gland (SMG) from radiation. This study's objectives were to: 1) elucidate the radiation-sparing capacity of the M-SGT, and 2) study the xerostomia-reducing potential of the M-SGT based on the University of Washington Quality-of-Life Questionnaire (UW-QOL).
Radiation therapy treatment plans were reviewed for all patients treated with surgery and RT who had a M-SGT at the University of Alberta Hospital during the study period. Outcomes included: 1) radiation dose received by the transferred SMG within the periparotid area compared to the submandibular triangle (ST), and 2) patient-reported saliva scores on the UW-QOL compared to historical controls without a gland transfer.
Twenty-two patients were included. The mean radiation dose received by the transferred SMG was 29.00 grays (Gy) (standard deviation 14.59 Gy), thus reducing the mean radiation dose to the SMG by a statistically significant 18.34 Gy (confidence interval 95% (13.37, 23.32), P < 0.01) compared to the ST and below the D50 of the SMG (34 Gy). Sixty-five percent of patients rated their saliva as normal or mildly reduced on the UW-QOL as compared to 16% of controls (P = 0.01).
The M-SGT technique is successful at reducing the radiation dose sustained by the SMG during adjuvant treatment and provides a significant improvement in xerostomia-related functional outcomes as compared to historical controls not receiving a gland transfer.
4 Laryngoscope, 130:925-929, 2020.
治疗晚期头颈部癌症通常包括手术加放射治疗（RT）。放疗引起的口干是这些治疗的常见后遗症。改良下颌下腺转移（M-SGT）术的发展是为了通过避免一个下颌下腺（SMG）受到放疗来减少口腔癌治疗中的口干。本研究的目的是：1）阐明 M-SGT 的放疗保护能力，2）根据华盛顿大学生活质量问卷（UW-QOL）研究 M-SGT 的减少口干的潜力。
对研究期间在阿尔伯塔大学医院接受手术和 RT 治疗并进行 M-SGT 的所有患者的放射治疗计划进行了回顾。结果包括：1）与下颌下三角（ST）相比，腮腺周围区域内转移的 SMG 接受的辐射剂量，以及 2）与未进行腺体转移的历史对照相比，UW-QOL 上患者报告的唾液评分。
纳入 22 例患者。转移的 SMG 接受的平均辐射剂量为 29.00 戈瑞（Gy）（标准差 14.59 Gy），因此与 ST 相比，SMG 接受的平均辐射剂量显著降低了 18.34 Gy（置信区间 95%（13.37, 23.32），P <0.01），低于 SMG 的 D50（34 Gy）。与 16%的对照组相比，65%的患者在 UW-QOL 上报告唾液正常或轻度减少（P = 0.01）。
M-SGT 技术成功地降低了辅助治疗期间 SMG 所承受的辐射剂量，并与未接受腺体转移的历史对照相比，在口干相关的功能结果方面有显著改善。
4 级喉镜，130：925-929，2020。
