Submandibular function recovery after IMRT in head and neck cancer: A prospective dose modelling study.

Submandibular function recovery after IMRT in head and neck cancer: A prospective dose modelling study. Radiother Oncol. 2018 Apr 30;: Authors: Murthy V, Lewis S, Kannan S, Khadanga CR, Rangarajan V, Joshi K, Gandhi M, Dey S, Rokde G, Budrukkar A, Gupta T, Laskar S, Agarwal JP Abstract PURPOSE: To estimate the dose response relationship for submandibular gland (SMG) recovery using salivary scintigraphy in patients diagnosed with head and neck cancer treated with curative image guided chemoradiation. MATERIAL AND METHODS: Ninety newly diagnosed head and neck cancer patients (T1-3, N0-2c, M0) treated with intensity modulated radiotherapy on a prospective clinical trial were assessed for salivary toxicity at predefined intervals using dynamic salivary scintigraphy. The SMG function was measured using salivary excretion fraction (SEF) ratios at baseline and 6 monthly. Tolerance dose (TD) 50 for submandibular gland was estimated from dose response curves. RESULTS: The mean SEF ratio of 180 SMGs decreased at 6 months with a nadir at 12 months after treatment (SEF ratio 15%) and progressively recovered over time reaching 38% over 24 months. There was significant inverse correlation between SEF ratio and mean SMG dose at 6 months (r = -0.18, p = 0.04); 12-months (r = -0.36, p 
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - Category: Radiology Authors: Tags: Radiother Oncol Source Type: research

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Conclusions: HART represents an attractive approach for patients with HNSCC where treatment intensification is indicated. PMID: 31519130 [PubMed - as supplied by publisher]
Source: Acta Oncologica - Category: Cancer & Oncology Authors: Tags: Acta Oncol Source Type: research
Conclusion: The mean QF based on UPI was found to be close to unity, which correlates with being a better IMRT plan. The present study suggested the existence of a moderate correlation between the calculated NTCP values and their respective severities of the organ at risk (OAR’s). Accelerated IMRT with chemotherapy is a clinically feasible option in the treatment of locally advanced head and neck squamous cell carcinoma (HNSCC) with encouraging initial tumor response and acceptable acute toxicities. PMID: 31450921 [PubMed - in process]
Source: Asian Pacific Journal of Cancer Prevention - Category: Cancer & Oncology Tags: Asian Pac J Cancer Prev Source Type: research
Proton therapy has an important role in the management of head and neck cancer, where the dosimetric characteristics of proton particles are advantageous for treating tumors in complex anatomic areas. In addition to highly targeted dose depositions owing to the Bragg peak and superior lateral dose distribution of proton therapy, the introduction of spot-scanning techniques that allow intensity-modulated proton therapy (IMPT) further improve dose distributions and normal-tissue sparing relative to intensity-modulated (photon) radiation therapy (IMRT), a finding that has been validated in case-matched analyses showing lower ...
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Original Article Source Type: research
Conclusions: Our results indicate that GRADX and PGM, which together serve as a proxy of dosimetric changes, provide valuable information for xerostomia prediction.
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
trois centres français Abstract Intensity-modulated radiation therapy (IMRT) is presently the recommended technique for the treatment of locally advanced head and neck carcinomas. Proton therapy would allow to reduce the volume of irradiated normal tissue and, thus, to decrease the risk of late dysphagia, xerostomia, dysgeusia and hypothyroidism. An exhaustive research was performed with the search engine PubMed by focusing on the papers about the physical difficulties that slow down use of proton therapy for head and neck carcinomas. Range uncertainties in proton therapy (±3 %) paradoxically li...
Source: Cancer Radiotherapie - Category: Cancer & Oncology Authors: Tags: Cancer Radiother Source Type: research
Abstract The treatment of locally advanced head and neck cancer (LAHNC) requires a multimodality approach. Radiotherapy with combination of chemotherapy are demonstrated to be effective, however, the treatment intensification leads to increased toxicity at the same time. The implementation of three-dimensional conformal radiotherapy (3D-CRT) allowed to irradiate the treatment volume more precisely with better surrounding healthy tissue sparing. Intensity modulated radiotherapy (IMRT) facilitated higher conformity in dose shaping to target volume. IMRT with simultaneous integrated boost (IMRT-SIB) offered the possi...
Source: Neoplasma - Category: Cancer & Oncology Authors: Tags: Neoplasma Source Type: research
Conclusions: 3D-HDR-BT achieves favorable clinical outcomes with mild late toxicity in patients with locally rNPC. Introduction Nasopharyngeal carcinoma (NPC), a tumor of epithelial origin, is a malignant disease of the head and neck common in southern China, especially in Guangdong province (1). As a result of advances in modern imaging and irradiation techniques, the 5-year overall survival (OS) of patients with newly diagnosed NPC without metastasis has reached 75% after external beam radiotherapy (EBRT) in Asia (2, 3). However, local recurrence, which occurs in 18–40% of patients, remains a major reason for...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Conclusions: Both salivary flow rate and xerostomia-related questions worsened at 3 months even with IMRT and showed a similar pattern of recovery.
Source: Journal of Cancer Research and Therapeutics - Category: Cancer & Oncology Authors: Source Type: research
Conclusion: The degree of PTV overlap with parotid (≥30%) and N + disease are the strongest predictors of poor parotid sparing by IMRT.
Source: Journal of Cancer Research and Therapeutics - Category: Cancer & Oncology Authors: Source Type: research
Conclusion: Postoperative IMRT of carcinoma buccal mucosa and alveolus resulted in the highest LC rate of all the treatment subgroups assessed hence should be generously recommended in such cases especially ones with unfavorable features such as close resection margin, nodal involvement, locally advanced tumor (>T1N0), or recurrent disease, respectively. Despite definitive IMRT, locoregional control in carcinoma buccal mucosa and alveolus remain unsatisfactory, comparable to that following definitive 3D-CRT.
Source: Journal of Cancer Research and Therapeutics - Category: Cancer & Oncology Authors: Source Type: research
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