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

Head Neck. 2016 Jul;38(7):1028-34. doi: 10.1002/hed.24398. Epub 2016 Feb 8.

Abstract

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.

Keywords: dosimetry; intensity-modulated radiotherapy; parotid gland; submandibular gland; volumetric-modulated arc therapies.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy*
  • Cohort Studies
  • Dose-Response Relationship, Radiation
  • Female
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Male
  • Middle Aged
  • Organs at Risk / radiation effects*
  • Prognosis
  • Radiation Injuries / prevention & control
  • Radiometry
  • Radiotherapy Dosage
  • Radiotherapy, Intensity-Modulated / methods*
  • Retrospective Studies
  • Salivary Glands / radiation effects*
  • Squamous Cell Carcinoma of Head and Neck
  • Survival Analysis
  • Treatment Outcome
  • Xerostomia / prevention & control*