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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2009
Randomized Controlled TrialA prospective study of salivary gland function in lymphoma patients receiving head and neck irradiation.
- Neesha A Rodrigues, Leah Killion, Gail Hickey, Barbara Silver, Chrystalla Martin, Mary Ann Stevenson, Peter M Mauch, and Andrea K Ng.
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
- Int. J. Radiat. Oncol. Biol. Phys. 2009 Nov 15; 75 (4): 1079-83.
PurposeTo determine the radiation dose-response relationship on salivary dysfunction and quality of life (QOL) over time in patients with lymphoma receiving radiation therapy (RT) to the head and neck (H&N).Methods And MaterialsWe conducted a prospective study on salivary-gland function in lymphoma patients receiving RT to the H&N. Fifteen patients were enrolled on the study. Dose-volume histograms and mean doses to the salivary glands were generated. Radiation-related toxicities and H&N-specific QOL were assessed before treatment and at prespecified time points posttreatment. Factors predicting a decrement in QOL were explored using Fisher's exact test.ResultsDuring RT, 47% of patients experienced Grade >or= 2 acute toxicity of the salivary gland, mucous membrane, or both. QOL scores improved over time, but up to one third of patients continued to have persistent oral symptoms at 2 years. At 6 months, a mean dose to at least one of the parotids of > 31 Gy was significantly associated with persistent dry mouth (100% vs. 17%, p = 0.02) and sticky saliva (100% vs. 25%, p = 0.04); a mean dose of > 11 Gy to the minor salivary glands was significantly associated with persistent sticky saliva (100% vs. 25%, p = 0.04), although the difference was no longer significant at 1 year.ConclusionsLimiting the mean parotid dose to
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