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Title: 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

Abstract

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 themore » 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.« less

Authors:
 [1];  [2];  [3];  [4];  [4];  [5];  [6];  [7];  [4];  [8]
  1. Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany) and Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center, Heidelberg (Germany). E-mail: m.muenter@dkfz.de
  2. Department of Radiation Oncology, St. Vincentius-Klinik Karlsruhe, Karlsruhe (Germany)
  3. (Germany)
  4. Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany)
  5. Department of Nuclear Medicine, University of Heidelberg, Heidelberg (Germany)
  6. Department of Radiation Oncology, St. Josef-Hospital Ruhr-University Bochum, Bochum (Germany)
  7. Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center, Heidelberg (Germany)
  8. Department of Medical Physics in Radiation Oncology, German Cancer Research Center, Heidelberg (Germany)
Publication Date:
OSTI Identifier:
20944713
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal 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)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; EXCRETION; HEAD; NECK; PATIENTS; RADIATION DOSES; RADIOTHERAPY; SALIVARY GLANDS; SCINTISCANNING; UPTAKE

Citation Formats

Muenter, Marc W., Hoffner, Simone, Department of Nuclear Medicine, University of Heidelberg, Heidelberg, Hof, Holger, Herfarth, Klaus K., Haberkorn, Uwe, Rudat, Volker, Huber, Peter, Debus, Juergen, and Karger, Christian P.. 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. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.09.035.
Muenter, Marc W., Hoffner, Simone, Department of Nuclear Medicine, University of Heidelberg, Heidelberg, Hof, Holger, Herfarth, Klaus K., Haberkorn, Uwe, Rudat, Volker, Huber, Peter, Debus, Juergen, & Karger, Christian P.. 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. United States. doi:10.1016/j.ijrobp.2006.09.035.
Muenter, Marc W., Hoffner, Simone, Department of Nuclear Medicine, University of Heidelberg, Heidelberg, Hof, Holger, Herfarth, Klaus K., Haberkorn, Uwe, Rudat, Volker, Huber, Peter, Debus, Juergen, and Karger, Christian P.. Thu . "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". United States. doi:10.1016/j.ijrobp.2006.09.035.
@article{osti_20944713,
title = {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},
author = {Muenter, Marc W. and Hoffner, Simone and Department of Nuclear Medicine, University of Heidelberg, Heidelberg and Hof, Holger and Herfarth, Klaus K. and Haberkorn, Uwe and Rudat, Volker and Huber, Peter and Debus, Juergen and Karger, Christian P.},
abstractNote = {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.},
doi = {10.1016/j.ijrobp.2006.09.035},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 3,
volume = 67,
place = {United States},
year = {Thu Mar 01 00:00:00 EST 2007},
month = {Thu Mar 01 00:00:00 EST 2007}
}