Changes in salivary gland function after radiotherapy of head and neck tumors measured by quantitative pertechnetate scintigraphy: Comparison of intensity-modulated radiotherapy and conventional radiation therapy with and without Amifostine
- Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany) and Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center, Heidelberg (Germany)
- Department of Radiation Oncology, St. Vincentius-Klinik Karlsruhe, Karlsruhe (Germany)
- Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany)
- Department of Nuclear Medicine, University of Heidelberg, Heidelberg (Germany)
- Department of Radiation Oncology, St. Josef-Hospital Ruhr-University Bochum, Bochum (Germany)
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center, Heidelberg (Germany)
- Department of Medical Physics in Radiation Oncology, German Cancer Research Center, Heidelberg (Germany)
Purpose: The aim of this study was to compare changes in salivary gland function after intensity-modulated radiotherapy (IMRT) and conventional radiotherapy (RT), with or without Amifostine, for tumors of the head-and-neck region using quantitative salivary gland scintigraphy (QSGS). Methods and Materials: A total of 75 patients received pre- and post-therapeutic QSGS to quantify the salivary gland function. In all, 251 salivary glands were independently evaluated. Changes in the maximum uptake ({delta}U) and relative excretion rate ({delta}F) both pre- and post-RT were determined to characterize radiation-induced changes in the salivary gland function. In addition, dose-response curves were calculated. Results: In all groups, maximum uptake and relative excretion rate were reduced after RT ({delta}U {<=}0 and {delta}F {<=}0). The reduction was significantly lower for IMRT than for conventional RT. For the parotid glands, the reduction was smaller for the IMRT-low than for the IMRT-high group. For the Amifostine-high and the conventional group the difference was significant only for one parameter ({delta}U, parotid and submandibular glands, p < 0.05). In contrast to this, the difference between the Amifostine-low and the conventional group was always significant or at least showed a clear trend for both changes in U and F. In regard to the endpoint 'reduction of the salivary gland excretion rate of more than 50%,' the dose-response curves yielded D{sub 50}-values of 34.2 {+-} 12.2 Gy for the conventionally treated group and 36.8 {+-} 2.9 Gy for the IMRT group. For the Amifostine group, an increased D{sub 50}-values of 46.3 {+-} 2.3 Gy was obtained. Conclusion: Intensity-modulated RT can significantly reduce the loss of parotid gland function when respecting a certain dose threshold. Conventional RT plus Amifostine prevents reduced salivary gland function only in the patient group treated with <40.6 Gy.
- OSTI ID:
- 20944713
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 67, Issue 3; Other Information: DOI: 10.1016/j.ijrobp.2006.09.035; PII: S0360-3016(06)03129-4; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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