Effect of Cisplatin on parotid gland function in concomitant radiochemotherapy.

Abstract

PURPOSE:

To determine the influence of concomitant radiochemotherapy with cisplatin on parotid gland tissue complication probability.

METHODS AND MATERIALS:

Patients treated with either radiotherapy (n = 61) or concomitant radiochemotherapy with cisplatin (n = 36) for head-and-neck cancer were prospectively evaluated. The dose and volume distributions of the parotid glands were noted in dose-volume histograms. Stimulated salivary flow rates were measured before, during the 2(nd) and 6(th) weeks and at 4 weeks and 6 months after the treatment. The data were fit using the normal tissue complication probability model of Lyman. Complication was defined as a reduction of the salivary flow rate to less than 25% of the pretreatment flow rate.

RESULTS:

The normal tissue complication probability model parameter TD(50) (the dose leading to a complication probability of 50%) was found to be 32.2 Gy at 4 weeks and 32.1 Gy at 6 months for concomitant radiochemotherapy and 41.1 Gy at 4 weeks and 39.6 Gy at 6 months for radiotherapy. The tolerated dose for concomitant radiochemotherapy was at least 7 to 8 Gy lower than for radiotherapy alone at TD(50).

CONCLUSIONS:

In this study, the concomitant radiochemotherapy tended to cause a higher probability of parotid gland tissue damage. Advanced radiotherapy planning approaches such as intensity-modulated radiotherapy may be particularly important for parotid sparing in radiochemotherapy because of cisplatin-related increased radiosensitivity of glands.

• Authors: Jeremias Hey, Jürgen Setz, Reinhard Gerlach, Dirk Vordermark, Christian R Gernhardt, Thomas Kuhnt
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 75 Issue 5 Pg. 1475-80 (Dec 01 2009) ISSN: 1879-355X [Electronic] United States
• PMID: 19515505 (Publication Type: Journal Article)

Chemical References

• Radiation-Sensitizing Agents
• Cisplatin

Topics

• Adult
• Aged
• Carcinoma, Squamous Cell (drug therapy, physiopathology, radiotherapy)
• Cisplatin (administration & dosage, adverse effects)
• Combined Modality Therapy (adverse effects, methods)
• Dose Fractionation, Radiation
• Female
• Head and Neck Neoplasms (drug therapy, physiopathology, radiotherapy)
• Humans
• Laryngeal Neoplasms (drug therapy, physiopathology, radiotherapy)
• Male
• Middle Aged
• Models, Statistical
• Mouth Neoplasms (drug therapy, physiopathology, radiotherapy)
• Parotid Gland (drug effects, physiology, radiation effects)
• Prospective Studies
• Radiation Injuries (chemically induced, physiopathology)
• Radiation-Sensitizing Agents (administration & dosage, adverse effects)
• Radiotherapy, Conformal (adverse effects)
• Salivation (drug effects, physiology, radiation effects)
• Time Factors