SU-D-204-04: Correlations Between Dosimetric Indices and Follow-Up Data for Salivary Glands Six Months After Radiation Therapy for Head and Neck Cancer

2016 ◽  
Vol 43 (6Part3) ◽  
pp. 3332-3333
Author(s):  
B Chera ◽  
A Price ◽  
M Kostich ◽  
R Amdur ◽  
W Mendenhall ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Salivary Glands ◽  
Neck Cancer ◽  
Dosimetric Indices

scholarly journals Reducing Xerostomia by Comprehensive Protection of Salivary Glands in Intensity-Modulated Radiation Therapy with Helical Tomotherapy Technique for Head-and-Neck Cancer Patients: A Prospective Observational Study

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Feng Teng ◽  
Wenjun Fan ◽  
Yanrong Luo ◽  
Zhongjian Ju ◽  
Hanshun Gong ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Salivary Glands ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Helical Tomotherapy ◽  
Clinical Stage ◽  
Flow Rates ◽  
Saliva Flow

Objective. This study aimed to analyze the effects of comprehensive protection of bilateral parotid glands (PG-T), contralateral submandibular gland (cSMG), and accessory salivary glands in the oral cavity (OC) by helical tomotherapy for head-and-neck cancer patients. Methods. Totally 175 patients with histologically confirmed head-and-neck cancer treated with helical tomotherapy were recruited. The doses delivered to PG-T, cSMG, and OC were constrained to be as low as possible in treatment planning. The saliva flow rates and xerostomia questionnaire were evaluated. Correlation between xerostomia and other clinical factors were assessed using univariate and multivariate models. The impact of salivary gland dose on locoregional (LR) recurrence was assessed by Cox analysis. ROC curve was used to determine the threshold of mean dose for each gland. Results. The median follow-up was 25 (19–36) months. The OC mean dose, PG-T mean dose, cSMG mean dose, age, clinical stage (II and III versus IV), and both unstimulated and stimulated saliva flow rates were significantly correlated with xerostomia. The OC mean dose, cSMG mean dose, age, and clinical stage were predictors of xerostomia after adjusting PG-T mean dose, and unstimulated and stimulated saliva flow rates. Xerostomia was significantly decreased when the mean doses of PG-T, cSMG, and OC were kept below 29.12Gy, 29.29Gy, and 31.44Gy, respectively. At 18 months after radiation therapy, early LR recurrence rate was only 4%. Conclusion. Comprehensive protection of salivary glands minimized xerostomia in head-and-neck cancer patients treated by helical tomotherapy, without increasing early LR recurrence risk.

scholarly journals Total plaque score helps to determine follow-up strategy for carotid artery stenosis progression in head and neck cancer patients after radiation therapy

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246684
Author(s):  
Chi-Hung Liu ◽  
Joseph Tung-Chieh Chang ◽  
Tsong-Hai Lee ◽  
Pi-Yueh Chang ◽  
Chien-Hung Chang ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Carotid Artery ◽  
Head And Neck ◽  
Neck Cancer ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Close Monitoring ◽  
Plaque Score

Background To identify predictors of carotid artery stenosis (CAS) progression in head and neck cancer (HNC) patients after radiation therapy (RT). Methods We included 217 stroke-naïve HNC patients with mild carotid artery stenosis after RT in our hospital. These patients underwent annual carotid duplex ultrasound (CDU) studies to monitor CAS progression. CAS progression was defined as the presence of ≥50% stenosis of the internal/common carotid artery on follow-up CDU. We recorded total plaque score (TPS) and determined the cut-off TPS to predict CAS progression. We categorized patients into high (HP) and low plaque (LP) score groups based on their TPS at enrolment. We analyzed the cumulative events of CAS progression in the two groups. Results The TPS of the CDU study at enrolment was a significant predictor for CAS progression (adjusted odds ratio [aOR] = 1.69, p = 0.002). The cut-off TPS was 7 (area under the curve: 0.800), and a TPS ≥ 7 strongly predicted upcoming CAS progression (aOR = 41.106, p = 0.002). The HP group had a higher risk of CAS progression during follow-up (adjusted hazard ratio = 6.15; 95% confident interval: 2.29–16.53) in multivariable Cox analysis, and also a higher trend of upcoming ischemic stroke (HP vs. LP: 8.3% vs. 2.2%, p = 0.09). Conclusions HNC patients with a TPS ≥ 7 in any CDU study after RT are susceptible to CAS progression and should receive close monitoring within the following 2 years.

scholarly journals Aldehyde dehydrogenase 3A1 activation prevents radiation-induced xerostomia by protecting salivary stem cells from toxic aldehydes

2018 ◽  
Vol 115 (24) ◽  
pp. 6279-6284 ◽  
Author(s):  
Julie P. Saiki ◽  
Hongbin Cao ◽  
Lauren D. Van Wassenhove ◽  
Vignesh Viswanathan ◽  
Joshua Bloomstein ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Salivary Glands ◽  
Aldehyde Dehydrogenase ◽  
Neck Cancer ◽  
Common Side Effect ◽  
Loss Of Function ◽  
And Function

Xerostomia (dry mouth) is the most common side effect of radiation therapy in patients with head and neck cancer and causes difficulty speaking and swallowing. Since aldehyde dehydrogenase 3A1 (ALDH3A1) is highly expressed in mouse salivary stem/progenitor cells (SSPCs), we sought to determine the role of ALDH3A1 in SSPCs using genetic loss-of-function and pharmacologic gain-of-function studies. Using DarkZone dye to measure intracellular aldehydes, we observed higher aldehyde accumulation in irradiated Aldh3a1−/− adult murine salisphere cells and in situ in whole murine embryonic salivary glands enriched in SSPCs compared with wild-type glands. To identify a safe ALDH3A1 activator for potential clinical testing, we screened a traditional Chinese medicine library and isolated d-limonene, commonly used as a food-flavoring agent, as a single constituent activator. ALDH3A1 activation by d-limonene significantly reduced aldehyde accumulation in SSPCs and whole embryonic glands, increased sphere-forming ability, decreased apoptosis, and improved submandibular gland structure and function in vivo after radiation. A phase 0 study in patients with salivary gland tumors showed effective delivery of d-limonene into human salivary glands following daily oral dosing. Given its safety and bioavailability, d-limonene may be a good clinical candidate for mitigating xerostomia in patients with head and neck cancer receiving radiation therapy.

scholarly journals Effectiveness of Fluoride Varnish Application as Cariostatic and Desensitizing Agent in Irradiated Head and Neck Cancer Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Kanchan P. Dholam ◽  
Priyanka Piyush Somani ◽  
Seema D. Prabhu ◽  
Shubhangi R. Ambre
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Fluoride Varnish ◽  
Good Compliance ◽  
Radiation Caries ◽  
Rate Of Increase

Objective. To evaluate the effectiveness of three-month fluoride varnish application on radiation caries and dental sensitivity and to assess compliance to three-month fluoride varnish application.Materials and Methods. 190 irradiated head and neck cancer patients were randomly selected and reviewed retrospectively. Oral prophylaxis, fluoride varnish application, and treatment of dental caries were done prior to radiation therapy. Patients were followed up at every three months for dental evaluation and fluoride varnish application. Decayed-missing-filling-teeth indices, dental sensitivity, and compliance to fluoride varnish application were noted for fifteen months and analyzed statistically.Results. Significant increase in decayed-missing-filling-teeth index was seen at nine(P=0.028), twelve(P=0.003)and fifteen(P=0.002)months follow-up. However, the rate of increase in decayed-missing-filling-teeth indices was 1.64/month which is less than the rate mentioned in the literature (2.5/month). There was no significant effect of sex(P=0.952)and surgery(P=0.672)on radiation caries, but site of disease(P=0.038)and radiation dose(P=0.015)were found to have statistically significant effect. Dental sensitivity decreased from 39% at 3 months to 25% at 15 months followup. 99% compliance to fluoride varnish application was seen till six months followup which decreased to 46% at fifteen months.Conclusion. Three-month fluoride varnish application is effective in decreasing radiation caries and sensitivity and has good compliance.

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