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Int J Radiat Oncol Biol Phys ; 75(4): 1079-83, 2009 Nov 15.
Article in English | MEDLINE | ID: mdl-19327910

ABSTRACT

PURPOSE: To determine the radiation dose-response relationship on salivary dysfunction and quality of life (QOL) over time in patients with lymphoma receiving radiation therapy (RT) to the head and neck (H&N). METHODS AND MATERIALS: We conducted a prospective study on salivary-gland function in lymphoma patients receiving RT to the H&N. Fifteen patients were enrolled on the study. Dose-volume histograms and mean doses to the salivary glands were generated. Radiation-related toxicities and H&N-specific QOL were assessed before treatment and at prespecified time points posttreatment. Factors predicting a decrement in QOL were explored using Fisher's exact test. RESULTS: During RT, 47% of patients experienced Grade >or= 2 acute toxicity of the salivary gland, mucous membrane, or both. QOL scores improved over time, but up to one third of patients continued to have persistent oral symptoms at 2 years. At 6 months, a mean dose to at least one of the parotids of > 31 Gy was significantly associated with persistent dry mouth (100% vs. 17%, p = 0.02) and sticky saliva (100% vs. 25%, p = 0.04); a mean dose of > 11 Gy to the minor salivary glands was significantly associated with persistent sticky saliva (100% vs. 25%, p = 0.04), although the difference was no longer significant at 1 year. CONCLUSIONS: Limiting the mean parotid dose to

Subject(s)
Hodgkin Disease/radiotherapy , Lymphoma, Non-Hodgkin/radiotherapy , Quality of Life , Radiation Injuries/complications , Salivary Glands/radiation effects , Adult , Aged , Amifostine/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Dose-Response Relationship, Radiation , Female , Hodgkin Disease/drug therapy , Humans , Lymphoma, Non-Hodgkin/drug therapy , Male , Middle Aged , Mucous Membrane/radiation effects , Parotid Gland/radiation effects , Prospective Studies , Radiation Injuries/prevention & control , Radiation-Protective Agents/therapeutic use , Saliva/radiation effects , Salivary Glands/pathology , Salivary Glands, Minor/radiation effects , Submandibular Gland/radiation effects , Time Factors , Xerostomia/etiology
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