Department of Radiotherapy and Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Stem Cell Transplantation, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
In Vivo. 2024 Nov-Dec;38(6):2795-2803. doi: 10.21873/invivo.13759.
BACKGROUND/AIM: Xerostomia following (chemo-) radiotherapy (CRT) is common in head and neck (HNC) patients. This prospective study focused on investigating the link between salivary gland function and the onset of malnutrition in HNC patients.
Between 2018 and 2020, 61 HNC patients scheduled for curative CRT were prospectively recruited. Nutritional status was assessed by bioelectrical impedance analysis (BIA) and xerostomia was evaluated based on the Common Terminology Criteria for Adverse Events, (CTCAE). Patient-reported outcomes for xerostomia-related symptoms, such as "dry mouth" and "sticky saliva", were also collected. Data were assessed at the beginning of therapy, during treatment, at the end of treatment, and during follow-up. Organs at risk were contoured including the submandibular and parotid glands. Dose-volume parameters were extracted for the mean Dose (D), V15 Gy, V30Gy and V45Gy.
No correlation was found between the dosimetric parameters [D, V15Gy (%), V30Gy (%) and V45Gy (%)] and the occurrence of malnutrition [defined by a fat-free mass index (FFMI) <15 kg/m (♀) and <17 kg/m (♂) kg/m and/or body-mass index (BMI) <18.5 kg/m] at any of the three time points tested. However, the volume of the parotid glands prior to therapy appeared to be related to the development of malnutrition. This effect was not observed with the submandibular glands. A cumulative parotid gland volume of 55.3 cm was identified as the threshold for malnutrition at the second follow-up examination.
Although none of the dosimetric factors were associated with the development of malnutrition, the baseline parotid gland volume emerged as an independent predictor of malnutrition in head and neck cancer patients with xerostomia.
背景/目的：头颈部（HNC）癌症患者在接受放化疗（CRT）后常出现口干。本前瞻性研究旨在探讨唾液腺功能与 HNC 患者营养不良发生的关系。
2018 年至 2020 年，前瞻性招募了 61 例计划接受根治性 CRT 的 HNC 患者。采用生物电阻抗分析（BIA）评估营养状况，根据常见不良事件术语标准（CTCAE）评估口干情况。还收集了与口干相关症状（如“口干”和“粘稠唾液”）的患者报告结果。在治疗开始时、治疗期间、治疗结束时和随访期间评估数据。勾画危险器官，包括颌下腺和腮腺。提取平均剂量（D）、V15Gy、V30Gy 和 V45Gy 的剂量-体积参数。
在任何三个测试时间点，剂量学参数（D、V15Gy（%）、V30Gy（%）和 V45Gy（%））与营养不良（定义为无脂肪质量指数（FFMI）<15 kg/m（♀）和<17 kg/m（♂）kg/m 和/或体质量指数（BMI）<18.5 kg/m）的发生均无相关性。然而，治疗前腮腺体积似乎与营养不良的发展有关。这种影响在颌下腺中没有观察到。在第二次随访检查中，确定腮腺总体积 55.3cm 为营养不良的阈值。
尽管没有一个剂量学因素与营养不良的发展相关，但基线腮腺体积是口干的头颈部癌症患者营养不良的独立预测因素。
