Dysphagia and xerostomia are the main sequellae of chemoradiotherapy for head and neck cancer, and the main factors in reducing long-term patient quality of life. IMRT uses advanced technology to focus the high radiation doses on the targets and avoid irradiation of non-involved tissues. The decisions about sparing organs and tissues whose damage causes xerostomia and dysphagia depends on the evidence for dose-response relationships for the organs causing these sequellae. This paper discusses the evidence for the contribution of radiotherapy to xerostomia via damage of the major salivary glands (parotid and submandibular) and minor salivary glands within the oral cavity, and the contribution of radiotherapy-related effect on important swallowing structures causing dysphagia. Recommendations for dose limits to these organs, based on measurements of xerostomia and dysphagia following radiotherapy, are provided here.
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http://dx.doi.org/10.1093/jrr/rrw047 | DOI Listing |
Radiother Oncol
December 2024
University of Groningen, University Medical Center Groningen, Department of Radiation Oncology, the Netherlands.
Purpose: To assess the feasibility and benefit of NTCP optimized aspiration-prevention treatment planning by sparing specific aspiration related organs at risk, and to assess the impact of baseline complaints on the planning results.
Materials And Methods: This in silico planning study included 30 HNC patients who were previously treated with definitive radiotherapy. New fully automated plans, allowing for sparing specific aspiration related organs at risk, were optimised directly on normal tissue complication probability (NTCP) models for common toxicities: xerostomia and dysphagia.
Radiother Oncol
December 2024
Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Switzerland. Electronic address:
Background: Radiotherapy is essential for treating head and neck cancer but often leads to severe toxicity. Traditional predictors include anatomical location, tumor extent, and dosimetric data. Recently, biomarkers have been explored to better predict and understand toxicity.
View Article and Find Full Text PDFInt J Radiat Oncol Biol Phys
December 2024
Department of Radiation Oncology, Sun Yat-sen University Cancer Center; Collaborative Innovation Center for Cancer Medicine; State Key Laboratory of Oncology in South China;Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy;Guangdong Provincial Clinical Research Center for Cancer, Guangzhou 510060, P.R. China. Electronic address:
Purpose: Our institution has developed an individualized elective primary tumor clinical target volume (CTVp) delineation protocol for nasopharyngeal carcinoma (NPC) based on stepwise tumor spread patterns in intensity-modulated radiotherapy (IMRT) for over ten years. Herein, we report the long-term efficacy and toxicities in NPC patients treated under this protocol.
Methods And Materials: A total of 7,262 histologically proven, nonmetastatic NPC patients treated with IMRT following this individualized delineation protocol were retrospectively evaluated.
Med Phys
December 2024
Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, Kansas, USA.
Medicina (Kaunas)
November 2024
Department of Personalised Medicine, State Research Institute Center for Innovative Medicine, Santariskiu st. 5, LT-08405 Vilnius, Lithuania.
Sjögren's disease (SjD), or primary Sjögren's syndrome (pSS), is a heterogeneous chronic autoimmune disorder with multiple clinical manifestations that can develop into non-Hodgkin's lymphoma in mucosa-associated lymphoid tissue. SjD is one of the autoimmune diseases with the maximum delayed diagnosis due to its insidious onset, heterogeneous clinical features and varied course. It is increasingly recognized that extraglandular manifestations represent a clinical challenge for patients with SjD.
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