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Title: Modeling of Salivary Production Recovery After Radiotherapy Using Mixed Models: Determination of Optimal Dose Constraint for IMRT Planning and Construction of Convenient Tools to Predict Salivary Function

Abstract

Purpose: The mathematical relationship between the dose to the parotid glands and salivary gland production needs to be elucidated. This study, which included data from patients included in a French prospective study assessing the benefit of intensity-modulated radiotherapy (RT), sought to elaborate a convenient and original model of salivary recovery. Methods and Materials: Between January 2001 and December 2004, 44 patients were included (35 with oropharyngeal and 9 with nasopharyngeal cancer). Of the 44 patients, 24 were treated with intensity-modulated RT, 17 with three-dimensional conformal RT, and 2 with two-dimensional RT. Stimulated salivary production was collected for {<=}24 months after RT. The data of salivary production, time of follow-up, and dose to parotid gland were modeled using a mixed model. Several models were developed to assess the best-fitting variable for the dose level to the parotid gland. Results: Models developed with the dose to the contralateral parotid fit the data slightly better than those with the dose to both parotids, suggesting that contralateral and ipsilateral parotid glands are not functionally equivalent even with the same dose level to the glands. The best predictive dose-value variable for salivary flow recovery was the volume of the contralateral parotid gland receiving >40 Gy.more » Conclusion: The results of this study show that the recommendation of a dose constraint for intensity-modulated RT planning should be established at the volume of the contralateral parotid gland receiving >40 Gy rather than the mean dose. For complete salivary production recovery after 24 months, the volume of the contralateral parotid gland receiving >40 Gy should be <33%. Our results permitted us to establish two convenient tools to predict the saliva production recovery function according to the dose received by the contralateral parotid gland.« less

Authors:
 [1];  [2]; ;  [1]; ; ;  [3]; ;  [4];  [5]; ;  [1]
  1. Department of Radiotherapy, Centre Antoine-Lacassagne, Canceropole PACA, Nice (France)
  2. Department of Biostatistics, Centre Antoine-Lacassagne, Canceropole PACA, Nice (France)
  3. Department of Otolaryngology, Head and Neck Surgery, Centre Antoine-Lacassagne, Canceropole PACA, Nice (France)
  4. Department of Medical Oncology, Centre Antoine-Lacassagne, Canceropole PACA, Nice (France)
  5. Department of Pathology, Centre Antoine-Lacassagne, Canceropole PACA, Nice (France)
Publication Date:
OSTI Identifier:
21172551
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 73; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2008.03.068; PII: S0360-3016(08)00673-1; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; PATIENTS; PLANNING; RADIATION DOSES; RADIOTHERAPY; RECOMMENDATIONS; SALIVA; SALIVARY GLANDS; SIMULATION

Citation Formats

Ortholan, Cecile, Chamorey, Emmanuel Phar, Benezery, Karen, Thariat, Juliette, Dassonville, Olivier, Poissonnet, Gilles, Bozec, Alexandre, Follana, Philippe, Peyrade, Frederique, Sudaka, Anne, Gerard, Jean Pierre, and Bensadoun, Rene Jean. Modeling of Salivary Production Recovery After Radiotherapy Using Mixed Models: Determination of Optimal Dose Constraint for IMRT Planning and Construction of Convenient Tools to Predict Salivary Function. United States: N. p., 2009. Web. doi:10.1016/j.ijrobp.2008.03.068.
Ortholan, Cecile, Chamorey, Emmanuel Phar, Benezery, Karen, Thariat, Juliette, Dassonville, Olivier, Poissonnet, Gilles, Bozec, Alexandre, Follana, Philippe, Peyrade, Frederique, Sudaka, Anne, Gerard, Jean Pierre, & Bensadoun, Rene Jean. Modeling of Salivary Production Recovery After Radiotherapy Using Mixed Models: Determination of Optimal Dose Constraint for IMRT Planning and Construction of Convenient Tools to Predict Salivary Function. United States. https://doi.org/10.1016/j.ijrobp.2008.03.068
Ortholan, Cecile, Chamorey, Emmanuel Phar, Benezery, Karen, Thariat, Juliette, Dassonville, Olivier, Poissonnet, Gilles, Bozec, Alexandre, Follana, Philippe, Peyrade, Frederique, Sudaka, Anne, Gerard, Jean Pierre, and Bensadoun, Rene Jean. 2009. "Modeling of Salivary Production Recovery After Radiotherapy Using Mixed Models: Determination of Optimal Dose Constraint for IMRT Planning and Construction of Convenient Tools to Predict Salivary Function". United States. https://doi.org/10.1016/j.ijrobp.2008.03.068.
@article{osti_21172551,
title = {Modeling of Salivary Production Recovery After Radiotherapy Using Mixed Models: Determination of Optimal Dose Constraint for IMRT Planning and Construction of Convenient Tools to Predict Salivary Function},
author = {Ortholan, Cecile and Chamorey, Emmanuel Phar and Benezery, Karen and Thariat, Juliette and Dassonville, Olivier and Poissonnet, Gilles and Bozec, Alexandre and Follana, Philippe and Peyrade, Frederique and Sudaka, Anne and Gerard, Jean Pierre and Bensadoun, Rene Jean},
abstractNote = {Purpose: The mathematical relationship between the dose to the parotid glands and salivary gland production needs to be elucidated. This study, which included data from patients included in a French prospective study assessing the benefit of intensity-modulated radiotherapy (RT), sought to elaborate a convenient and original model of salivary recovery. Methods and Materials: Between January 2001 and December 2004, 44 patients were included (35 with oropharyngeal and 9 with nasopharyngeal cancer). Of the 44 patients, 24 were treated with intensity-modulated RT, 17 with three-dimensional conformal RT, and 2 with two-dimensional RT. Stimulated salivary production was collected for {<=}24 months after RT. The data of salivary production, time of follow-up, and dose to parotid gland were modeled using a mixed model. Several models were developed to assess the best-fitting variable for the dose level to the parotid gland. Results: Models developed with the dose to the contralateral parotid fit the data slightly better than those with the dose to both parotids, suggesting that contralateral and ipsilateral parotid glands are not functionally equivalent even with the same dose level to the glands. The best predictive dose-value variable for salivary flow recovery was the volume of the contralateral parotid gland receiving >40 Gy. Conclusion: The results of this study show that the recommendation of a dose constraint for intensity-modulated RT planning should be established at the volume of the contralateral parotid gland receiving >40 Gy rather than the mean dose. For complete salivary production recovery after 24 months, the volume of the contralateral parotid gland receiving >40 Gy should be <33%. Our results permitted us to establish two convenient tools to predict the saliva production recovery function according to the dose received by the contralateral parotid gland.},
doi = {10.1016/j.ijrobp.2008.03.068},
url = {https://www.osti.gov/biblio/21172551}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 1,
volume = 73,
place = {United States},
year = {Thu Jan 01 00:00:00 EST 2009},
month = {Thu Jan 01 00:00:00 EST 2009}
}