Intensity-modulated radiotherapy or volumetric-modulated arc therapy in patients with head and neck cancer: Focus on salivary glands dosimetry.

Alexis Vallard Jean-Baptiste Guy Sylvie Mengue Ndong Nicolas Vial Romain Rivoirard Pierre Auberdiac Benoîte Méry Julien Langrand-Escure Sophie Espenel Coralie Moncharmont Majed Ben Mrad Peng Diao Dominique Goyet Nicolas Magné

Head Neck

Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint-Priest en Jarez, France.

Published: July 2016

- The study investigates salivary gland dosimetry in patients with head and neck squamous cell carcinoma (HNSCC) receiving advanced radiotherapy techniques, focusing on volumetric-modulated arc therapy (VMAT) and intensity-modulated RT (IMRT).
- Researchers analyzed data from 609 patients and found that the doses received by salivary glands varied widely, highlighting a concerning level of exposure that can lead to dysfunction.
- The findings suggest that current treatment guidelines do not adequately consider the protection of submandibular glands, indicating that ensuring effective treatment for the target area still takes precedence over the preservation of surrounding organs at risk.

Background: Despite radiotherapy (RT) technical improvements, high salivary dysfunction rates are still reported in patients with head and neck squamous cell carcinoma (HNSCC). The purpose of the present study was to report salivary glands dosimetry with volumetric-modulated arc therapy (VMAT) and intensity-modulated RT (IMRT).

Methods: Dosimetry of consecutive patients receiving IMRT or VMAT for proven HNSCC between 2007 and 2013 were retrospectively reviewed.

Results: Data of 609 patients were studied. Mean dose, mean maximum dose, and mean percentage of salivary gland volume receiving at least 26 Gy (V26) of the contralateral parotid were 24.50 Gy (range, 0-70.4 Gy), 39.08 Gy (range, 0.38-76.45 Gy), and 40.92% (range, 0% to 100%), respectively. Mean and maximum dose on contralateral submandibular gland were 48.18 Gy (range, 0.19-70.73 Gy), and 61.25 Gy (range, 0-75.8 Gy), respectively.

Conclusion: Target volume coverage still has to be prioritized over organs at risk (OAR) sparing with new RT techniques. Submandibular glands are not sufficiently taken into account in guidelines. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1028-1034, 2016.

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http://dx.doi.org/10.1002/hed.24398	DOI Listing

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