• Pètra M Braam, Chris H J Terhaard, Judith M Roesink, and Cornelis P J Raaijmakers.
• Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands. P.M.Braam@umcutrecht.nl
• Int. J. Radiat. Oncol. Biol. Phys. 2006 Nov 15; 66 (4): 975-80.

PurposeXerostomia is a severe complication after radiotherapy for oropharyngeal cancer, as the salivary glands are in close proximity with the primary tumor. Intensity-modulated radiotherapy (IMRT) offers theoretical advantages for normal tissue sparing. A Phase II study was conducted to determine the value of IMRT for salivary output preservation compared with conventional radiotherapy (CRT).Methods And MaterialsA total of 56 patients with oropharyngeal cancer were prospectively evaluated. Of these, 30 patients were treated with IMRT and 26 with CRT. Stimulated parotid salivary flow was measured before, 6 weeks, and 6 months after treatment. A complication was defined as a stimulated parotid flow rate <25% of the preradiotherapy flow rate.ResultsThe mean dose to the parotid glands was 48.1 Gy (SD 14 Gy) for CRT and 33.7 Gy (SD 10 Gy) for IMRT (p < 0.005). The mean parotid flow ratio 6 weeks and 6 months after treatment was respectively 41% and 64% for IMRT and respectively 11% and 18% for CRT. As a result, 6 weeks after treatment, the number of parotid flow complications was significantly lower after IMRT (55%) than after CRT (87%) (p = 0.002). The number of complications 6 months after treatment was 56% for IMRT and 81% for CRT (p = 0.04).ConclusionsIMRT significantly reduces the number of parotid flow complications for patients with oropharyngeal cancer.

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