Purpose: Irradiation of the parotid glands causes salivary dysfunction, resulting in reduced salivary flow. Recovery can be seen with time; however, long-term prospective data are lacking. The objective of this study was to analyze the long-term parotid gland function after irradiation for head-and-neck cancer.
Methods And Materials: A total of 52 patients with head-and-neck cancer and treated with radiotherapy (RT) were prospectively evaluated. Stimulated bilateral parotid salivary flow rates were measured before RT and 6 weeks, 6 months, 12 months, and at least 3.5 years after RT completion. A complication was defined as a stimulated parotid flow rate of <25% of the pre-RT flow rate. The normal tissue complication probability model proposed by Lyman was fit to the data. Multilevel techniques were used to model the patterns of flow rates with time.
Results: The mean stimulated flow rate of the parotid glands before RT was 0.31 mL/min (standard deviation [SD], 0.21). This was reduced to 0.14 mL/min (SD, 0.15) at 6 weeks after RT and recovered to 0.20 mL/min (SD, 0.22) at 6 months and 0.19 mL/min (SD, 0.21) at 12 months after RT. The mean stimulated flow rate was 0.25 mL/min (SD, 0.28) 5 years after RT. The mean dose to the parotid gland resulting in a 50% complication probability increased from 34 Gy at 6 weeks to 40 Gy at 6 months, 42 Gy at 12 months, and 46 Gy at 5 years after RT. Multilevel modeling indicated that both dose and time were significantly associated with the flow ratio.
Conclusion: Salivary output can still recover many years after RT. At 5 years after RT, we found an increase in the salivary flow rate of approximately 32% compared with at 12 months after RT.
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http://dx.doi.org/10.1016/j.ijrobp.2004.12.015 | DOI Listing |
Discov Med
December 2024
Department of Biochemistry and General Chemistry, Medical College of the University of Rzeszów, 35-959 Rzeszów, Poland.
Photodynamic therapy (PDT) is emerging as a promising treatment for many diseases. This non-invasive approach uses photosensitizing agents and light to selectively destroy abnormal cells, providing a valuable alternative to traditional treatments. Scientists are investigating the use of PDT in various areas of the head, and their work is focused on a growing number of new discoveries and methods for treating cancer.
View Article and Find Full Text PDFOphthalmic Plast Reconstr Surg
December 2024
Department of Ophthalmology, Liverpool Hospital, Liverpool, New South Wales.
Purpose: Microcystic adnexal carcinoma (MAC) is a locally aggressive adnexal carcinoma of the head and neck, which has a high tendency for recurrence. MAC rarely has distant metastasis, with only one previously reported case originating from the periorbital region. We present a patient with periorbital MAC with distant metastasis and a review of all reported patients with metastatic disease.
View Article and Find Full Text PDFPurpose: There is no current standard treatment regimen for carcinoma ex pleomorphic adenoma (CXPA) of the lacrimal gland. Neoadjuvant intraarterial cytoreductive chemotherapy (IACC) followed by multimodal therapy has achieved good locoregional control in adenoid cystic carcinoma of the lacrimal gland. We reviewed our experience with neoadjuvant IACC followed by multimodal therapy for CXPA of the lacrimal gland.
View Article and Find Full Text PDFBackground: Adaptive radiotherapy (ART) involves the continuous adaptation of the radiation plan according to patient- and tumor-specific feedback. In online ART, the plan is optimized in real time during the treatment; in offline ART, the plan is recalculated between treatment sessions. Hybrid linear accelerators with integrated CT, MRI, or PET are required to perform online ART.
View Article and Find Full Text PDFInt J Radiat Oncol Biol Phys
December 2024
Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, China; Fujian Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China. Electronic address:
Background: To report long-term results of cervical node-positive (CLN+) nasopharyngeal carcinoma (NPC) patients treated with IMRT with one-step nodal clinical target volume (CTVn) delineation by geometric-anatomic expansion from the nodal gross target volume (GTVn).
Materials: CLN+ NPC treated with the same one-step-CTVn delineation in two Chinese academic centers were pooled for this study. GTVn was prescribed to 70 Gy equivalent, CTVn1 was omitted, CTVn2 was prescribed to 45-55 Gy equivalent and defined as GTVn + 3 mm geometric expansion (5 mm if radiological extranodal extension-positive, rENE+) + elective nodal regions defined by anatomic boundary of cervical nodal levels.
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