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Prospective randomized study of intensity-modulated radiotherapy on salivary gland function in early-stage nasopharyngeal carcinoma patients.
J Clin Oncol. 2007 Nov 01; 25(31):4873-9.JC

Abstract

PURPOSE

This randomized trial compared the rates of delayed xerostomia between two-dimensional radiation therapy (2DRT) and intensity-modulated radiation therapy (IMRT) in the treatment of early-stage nasopharyngeal carcinoma (NPC).

PATIENTS AND METHODS

Between November 2001 and December 2003, 60 patients with T1-2bN0-1M0 NPC were randomly assigned to receive either IMRT or 2DRT. Primary end point was incidence of observer-rated severe xerostomia at 1 year after treatment based on Radiotherapy Oncology Group /European Organisation for the Research and Treatment of Cancer late radiation morbidity scoring criteria. Parallel assessment with patient-reported outcome, stimulated parotid flow rate (SPFR), and stimulated whole saliva flow rate (SWSFR) were also made.

RESULTS

At 1 year after treatment, patients in IMRT arm had lower incidence of observer-rated severe xerostomia than patients in the 2DRT arm (39.3% v 82.1%; P = .001), parallel with a higher fractional SPFR (0.90 v 0.05; P < .0001), and higher fractional SWSFR (0.41 v 0.20; P = .001). As for patient's subjective feeling, although a trend of improvement in patient-reported outcome was observed after IMRT, recovery was incomplete and there was no significant difference in patient-reported outcome between the two arms.

CONCLUSION

IMRT is superior to 2DRT in preserving parotid function and results in less severe delayed xerostomia in the treatment of early-stage NPC. Incomplete improvement in patient's subjective xerostomia with parotid-sparing IMRT reflects the need to enhance protection of other salivary glands.

Authors+Show Affiliations

State Key Laboratory in Oncology in South China, Sir Y.K. Pao Centre for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17971582

Citation

Kam, Michael K M., et al. "Prospective Randomized Study of Intensity-modulated Radiotherapy On Salivary Gland Function in Early-stage Nasopharyngeal Carcinoma Patients." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 25, no. 31, 2007, pp. 4873-9.
Kam MK, Leung SF, Zee B, et al. Prospective randomized study of intensity-modulated radiotherapy on salivary gland function in early-stage nasopharyngeal carcinoma patients. J Clin Oncol. 2007;25(31):4873-9.
Kam, M. K., Leung, S. F., Zee, B., Chau, R. M., Suen, J. J., Mo, F., Lai, M., Ho, R., Cheung, K. Y., Yu, B. K., Chiu, S. K., Choi, P. H., Teo, P. M., Kwan, W. H., & Chan, A. T. (2007). Prospective randomized study of intensity-modulated radiotherapy on salivary gland function in early-stage nasopharyngeal carcinoma patients. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 25(31), 4873-9.
Kam MK, et al. Prospective Randomized Study of Intensity-modulated Radiotherapy On Salivary Gland Function in Early-stage Nasopharyngeal Carcinoma Patients. J Clin Oncol. 2007 Nov 1;25(31):4873-9. PubMed PMID: 17971582.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective randomized study of intensity-modulated radiotherapy on salivary gland function in early-stage nasopharyngeal carcinoma patients. AU - Kam,Michael K M, AU - Leung,Sing-Fai, AU - Zee,Benny, AU - Chau,Ricky M C, AU - Suen,Joyce J S, AU - Mo,Frankie, AU - Lai,Maria, AU - Ho,Rosalie, AU - Cheung,Kin-yin, AU - Yu,Brian K H, AU - Chiu,Samuel K W, AU - Choi,Peter H K, AU - Teo,Peter M L, AU - Kwan,Wing-hong, AU - Chan,Anthony T C, PY - 2007/11/1/pubmed PY - 2007/12/6/medline PY - 2007/11/1/entrez SP - 4873 EP - 9 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J Clin Oncol VL - 25 IS - 31 N2 - PURPOSE: This randomized trial compared the rates of delayed xerostomia between two-dimensional radiation therapy (2DRT) and intensity-modulated radiation therapy (IMRT) in the treatment of early-stage nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS: Between November 2001 and December 2003, 60 patients with T1-2bN0-1M0 NPC were randomly assigned to receive either IMRT or 2DRT. Primary end point was incidence of observer-rated severe xerostomia at 1 year after treatment based on Radiotherapy Oncology Group /European Organisation for the Research and Treatment of Cancer late radiation morbidity scoring criteria. Parallel assessment with patient-reported outcome, stimulated parotid flow rate (SPFR), and stimulated whole saliva flow rate (SWSFR) were also made. RESULTS: At 1 year after treatment, patients in IMRT arm had lower incidence of observer-rated severe xerostomia than patients in the 2DRT arm (39.3% v 82.1%; P = .001), parallel with a higher fractional SPFR (0.90 v 0.05; P < .0001), and higher fractional SWSFR (0.41 v 0.20; P = .001). As for patient's subjective feeling, although a trend of improvement in patient-reported outcome was observed after IMRT, recovery was incomplete and there was no significant difference in patient-reported outcome between the two arms. CONCLUSION: IMRT is superior to 2DRT in preserving parotid function and results in less severe delayed xerostomia in the treatment of early-stage NPC. Incomplete improvement in patient's subjective xerostomia with parotid-sparing IMRT reflects the need to enhance protection of other salivary glands. SN - 1527-7755 UR - https://www.unboundmedicine.com/medline/citation/17971582/Prospective_randomized_study_of_intensity_modulated_radiotherapy_on_salivary_gland_function_in_early_stage_nasopharyngeal_carcinoma_patients_ L2 - https://ascopubs.org/doi/10.1200/JCO.2007.11.5501?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -