Journal
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
Volume 76, Issue 3, Pages S58-S63Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.ijrobp.2009.06.090
Keywords
Xerostomia; salivary parotid glands; submandibular salivary glands; radiotherapy; dose-volume effects
Funding
- National Institutes of Health [R01 CA85181, CA69579]
- American Association of Medical Physicists
- American Society of Therapeutic Radiology
- NATIONAL CANCER INSTITUTE [R29CA069579, R01CA069579, R01CA085181] Funding Source: NIH RePORTER
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Publications relating parotid dose-volume characteristics to radiotherapy-induced salivary toxicity were reviewed. Late salivary dysfunction has been correlated to the mean parotid gland dose, with recovery occurring with time. Severe xerostomia (defined as long-term salivary function of <25% of baseline) is usually avoided if at least one parotid gland is spared to a mean dose of less than approximate to 20 Gy or if both glands are spared to less than approximate to 25 Gy (mean dose). For complex, partial-volume RT patterns (e.g., intensity-modulated radiotherapy), each parotid mean dose should be kept as low as possible, consistent with the desired clinical target volume coverage. A lower parotid mean dose usually results in better function. Submandibular gland sparing also significantly decreases the risk of xerostomia. The currently available predictive models are imprecise, and additional study is required to identify more accurate models of xerostomia risk. (C) 2010 Elsevier Inc.
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