A study on the impact of patient-related parameters in the ability to spare parotid glands by intensity-modulated radiotherapy for head and neck squamous cell carcinomas

Bhanu Bandlamudi, Krishna Sharan, Prahlad Yathiraj, Anshul Singh, Anusha Reddy, Donald Fernandes, Vidyasagar Srinivasa

Research output: Contribution to journalArticle

Abstract

Aims and Objectives: This study aims to study the effect of geometric- A nd patient-related variables in achieving the desired dose-volume constraints to parotid for patients undergoing definitive/adjuvant intensity-modulated radiotherapy (IMRT) for head and neck squamous cell carcinomas (HNSCC). Subjects and Methods: This retrospective study considered HNSCC patients who underwent IMRT at our center between 2009 and 2014. Patients' details and dose-volume parameters were collected, and correlated with dose to parotids using Pearson's correlation test. Results: Sixty-seven patients were found to be eligible. Oral primary predominated (37.3%) and 53 (79%) had locally advanced disease. The parotid volume (PV) had no impact on mean dose. There was a negative linear correlation between the ratio (Parotid-planning target volume [PTV] overlap)/PV and mean dose to the whole parotid (y = 1.14-0.011×; R2 = 0.509; P = 0.001), suggesting that a ratio of 0.7 resulted in mean dose ≥ 40 Gy and potentially irreversible xerostomia. No association was found between site of primary and parotid dose, but node-positive (N+) patients received significantly higher dose compared to N0 patients (34.5 Gy vs. 29.5 Gy; P = 0.001). N + patients persisted to receive higher dose even when T stage was accounted for (32.5 Gy vs. 28.9 Gy for </= T2, 35.4 Gy vs. 30.1 Gy for > T2; P = 0.003). On the last follow-up, 35 patients (52%) had >/=Grade II xerostomia. Average mean dose to combined PV was higher in patients with > grade I xerostomia compared to patients with </=Grade I (35 Gy vs. 29 Gy; P = 0.01). Conclusion: The degree of PTV overlap with parotid (≥30%) and N + disease are the strongest predictors of poor parotid sparing by IMRT.

Original languageEnglish
Pages (from-to)1220-1224
Number of pages5
JournalJournal of Cancer Research and Therapeutics
Volume14
Issue number6
DOIs
Publication statusPublished - 01-10-2018

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Intensity-Modulated Radiotherapy
Parotid Gland
Xerostomia
Carcinoma, squamous cell of head and neck
Adjuvant Radiotherapy
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Bandlamudi, Bhanu ; Sharan, Krishna ; Yathiraj, Prahlad ; Singh, Anshul ; Reddy, Anusha ; Fernandes, Donald ; Srinivasa, Vidyasagar. / A study on the impact of patient-related parameters in the ability to spare parotid glands by intensity-modulated radiotherapy for head and neck squamous cell carcinomas. In: Journal of Cancer Research and Therapeutics. 2018 ; Vol. 14, No. 6. pp. 1220-1224.
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A study on the impact of patient-related parameters in the ability to spare parotid glands by intensity-modulated radiotherapy for head and neck squamous cell carcinomas. / Bandlamudi, Bhanu; Sharan, Krishna; Yathiraj, Prahlad; Singh, Anshul; Reddy, Anusha; Fernandes, Donald; Srinivasa, Vidyasagar.

In: Journal of Cancer Research and Therapeutics, Vol. 14, No. 6, 01.10.2018, p. 1220-1224.

Research output: Contribution to journalArticle

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T1 - A study on the impact of patient-related parameters in the ability to spare parotid glands by intensity-modulated radiotherapy for head and neck squamous cell carcinomas

AU - Bandlamudi, Bhanu

AU - Sharan, Krishna

AU - Yathiraj, Prahlad

AU - Singh, Anshul

AU - Reddy, Anusha

AU - Fernandes, Donald

AU - Srinivasa, Vidyasagar

PY - 2018/10/1

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