1. Clinical and dosimetric predictors of physician and patient reported xerostomia following intensity modulated radiotherapy for nasopharyngeal cancer - A prospective cohort analysis.
- Author
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Sommat K, Hussain A, Ong WS, Yit NLF, Khoo JBK, Soong YL, Wee JTS, Fong KW, and Tan TWK
- Subjects
- Adult, Aged, Clinical Trials, Phase II as Topic, Clinical Trials, Phase III as Topic, Cohort Studies, Dose-Response Relationship, Radiation, Female, Humans, Male, Middle Aged, Parotid Gland radiation effects, Patient Reported Outcome Measures, Prospective Studies, Radiation Injuries diagnosis, Radiotherapy, Intensity-Modulated adverse effects, Randomized Controlled Trials as Topic, Surveys and Questionnaires, Xerostomia diagnosis, Young Adult, Nasopharyngeal Carcinoma radiotherapy, Nasopharyngeal Neoplasms radiotherapy, Radiation Injuries etiology, Xerostomia etiology
- Abstract
Background and Purpose: To compare physician and patient reported xerostomia and correlate xerostomia with dosimetric and clinical parameters for nasopharyngeal cancer (NPC) patients treated with intensity modulated radiotherapy (IMRT) and chemotherapy., Patients and Methods: We analyzed the data of 172 patients with locally advanced NPC. Xerostomia was evaluated via physician-rated xerostomia based on RTOG morbidity score (E1), patient-rated dry mouth (E2) and patient-rated sticky saliva (E3) based on EORTC QLQ-HN35 questionnaire. Primary endpoint was the presence of moderate to severe xerostomia at 2-year after completion of IMRT., Results: The levels of physician reported xerostomia (E1) were consistently lower than patient reported dry mouth (E2) over time. The incidence of patients with xerostomia at 3-month post RT was 58% based on E1, 70% based on E2, and 51% based on E3. The corresponding incidence rates at 2-year post RT was 26% (E1), 36% (E2) and 21% (E3). The incidence of patients with xerostomia at 1-year post RT was close to that at 2-year post RT for all the 3 endpoints. The average Dmean of parotid glands was 41.5 Gy (range: 31.0 Gy-65.9 Gy, median: 40.7 Gy). No dosimetric parameters were significantly associated with xerostomia., Conclusion: Significant proportion of patients still experienced long term xerostomia with IMRT. Dose-effect relationships between xerostomia and the parotid glands were not observed in this study., (Copyright © 2019 Elsevier B.V. All rights reserved.) more...
- Published
- 2019
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