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Xerostomia in patients treated for oropharyngeal carcinoma: Comparing linear accelerator–based intensity‐modulated radiation therapy with helical tomotherapy
Author(s) -
Fortin Israël,
Fortin Bernard,
Lambert Louise,
Clavel Sébastien,
Alizadeh Moein,
Filion Edith J.,
Soulières Denis,
Bélair Ma,
Guertin Louis,
NguyenTan Phuc Felix
Publication year - 2014
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23463
Subject(s) - tomotherapy , medicine , parotid gland , incidence (geometry) , radiation therapy , nuclear medicine , retrospective cohort study , radiology , surgery , pathology , physics , optics
Background In comparison to sliding‐window intensity‐modulated radiation therapy (sw‐IMRT), we hypothesized that helical tomotherapy (HT) would achieve similar locoregional control and, at the same time, decrease the parotid gland dose, thus leading to a xerostomia reduction. Methods The association between radiation techniques, mean parotid dose, and xerostomia incidence, was reviewed in 119 patients with advanced oropharyngeal carcinoma treated with concurrent chemoradiation using sw‐IMRT ( n = 59) or HT ( n = 60). Results Ipsilateral and contralateral parotid mean doses were significantly lower for patients treated with HT versus sw‐IMRT: 24 Gy versus 32 Gy ipsilaterally and 20 Gy versus 25 Gy contralaterally. The incidence of grade ≥2 xerostomia was significantly lower in the HT group than in the sw‐IMRT group: 12% versus 78% at 6 months, 3% versus 51% at 12 months, and 0% versus 25% at 24 months. Total parotid mean dose <25 Gy was strongly associated to a lower incidence of grade ≥2 xerostomia at 6, 12, and 24 months. Conclusion This retrospective series suggests that using HT can better spare the parotid glands while respecting quantitative analysis of normal tissue effects in the clinic (QUANTEC)'s criteria. © 2013 Wiley Periodicals, Inc. Head Neck 36: 1343–1348, 2014