Comparative evaluation of the doses received by the parotid glands as predictors of xerostomia be 3D-CRT, IMRT and VMAT irradiation techniques in local advanced nasopharynx cancer

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Published Oct 1, 2017
DOI: https://doi.org/10.22551/2017.16.0403.10107
Camil Mireștean Călin Gheorghe Buzea Irina Butuc Alexandru Zara Dragoș Teodor Iancu

Abstract

Xerostomia is commonly associated with the radio-chemotherapy treatment of the head and neck cancers. The risk increases with increasing doses received by the parotid. Severe xerostomia (defined as long-term salivary function of < 25% of baseline) may be avoided if at least one parotid gland receives less than 20 Gy. The combined treatment with cisplatin regarded as bringing a significant benefit in survival with concurrent radiotherapy is associated with increased risk of late toxicity. Intensity-modulated radiotherapy (IMRT) is considered the radio-therapeutic standard in the management of head and neck cancer. Purpose: to evaluate the possibility of modern techniques to reduce radiation doses to parotid glands compared to conventional 3D-CRT radiotherapy even if the parotid glands are not delineated as organs at risk (OAR) and dosimetric constraints are not applied. Methods: For 10 locally advanced nasopharyngeal cancer cases treated by radiotherapy with curative intent using 3D-CRT technique, alternative IMRT and VMAT plans were proposed without applying dosimetric constraints for parotid glands. Results: IMRT and VMAT techniques reduce the maximum dose (Dmax) and the mean dose (Dmean) for both parotid glands compared to the 3D-CRT technique. The treatment plans were comparatively analyzed in terms of doses received by both parotid glands. Conclusions: Modern radiotherapy techniques implementation can reduce the dose received by the parotids even in the absence of contouring them as organs at risk, reducing xerostomia and ensuring a better quality of life for the nasopharynx cancer radio-treated patients.

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Keywords

nasopharyngeal cancer, intensity modulated radiation therapy, volumetric modulated arc therapy, xerostomia

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How to Cite
Mireștean, C., Buzea, C. G., Butuc, I., Zara, A., & Iancu, D. T. (2017). Comparative evaluation of the doses received by the parotid glands as predictors of xerostomia be 3D-CRT, IMRT and VMAT irradiation techniques in local advanced nasopharynx cancer. Archive of Clinical Cases, 4(3), Arch Clin Cases 2017; 4(3):146-153. https://doi.org/10.22551/2017.16.0403.10107
Issue
Vol. 4 No. 3 (2017)
Section
Original studies

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How to Cite

Mireștean, C., Buzea, C. G., Butuc, I., Zara, A., & Iancu, D. T. (2017). Comparative evaluation of the doses received by the parotid glands as predictors of xerostomia be 3D-CRT, IMRT and VMAT irradiation techniques in local advanced nasopharynx cancer. Archive of Clinical Cases, 4(3), Arch Clin Cases 2017; 4(3):146-153. https://doi.org/10.22551/2017.16.0403.10107