PAROTID SPARING IRRADIATION FOR THE HEAD AND NECK CANCERS
Abstract
Parotid sparing is usually accomplished by irradiating the ipsilateral side of the neck while avoiding the opposite parotid. Tumor site, size, pathology and risk of lymphatic metastases dictate the specific anatomy and the amount of tissue that must be irradiated. It has been shown that approximately two third of the patients receiving radical radiation therapy for head and neck cancer experience weight loss1.The amount of weight loss is maximal at three months after irradiation and recovers slowely thereafter. Weight loss during and immediately after treatment is due to acute mucosal reaction, whereas at three to six months later it is due to xerostomia and its sequelae. The greatest weight loss is experienced by patients whose parotid glands are irradiated during the course of treatment for cancers of the oral cavity and oropharynx. Parotid gland function can be spared with three dimensional treatment planning with unilateral head and neck cancers2.Retrospective analysis of 114 irradiated head and neck cancer patients showed that weight correlated with parotid function3,4. When both parotids were irradiated body weight fell to a nadir of minus 14 %, then gradually rose over the ensuing four years but never fully recovered. When one parotid was irradiated and the opposite was avoided, weight fell to a nadir of minus 4 % of the initial weight, fully recovered with in one year and paralleled the weigh of the controls whose parotids were not irradiatedReferences
Jhonston, Catherine A,. and Keane, Thomas J., Weight Loss in Patients Receiving Radical Radiation Therapy for Head and Neck Cancer: A Prospective Study, Journal of Parenteral and Enteral Nutrition, Vol. 6, No. 5, September/October 1982.
Jones RE, Takeuchi T, Eisbruch A, D’Hondt E, Hazuka M, Ship JA. Ipsilateral parotid sparing study in head and neck cancer patients who receive radiation therapy: results after 1 year. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996 Jun;81(6) : 642-8.
Marks, J.E., and Rao, D.V., Body Weight in Relation to parotid Irradiation, Unpublished Data.
Reddy SP, Leman CR, Marks JE, Emami B. Parotid Sparing Irradiation for Cancer of the Oral Cavity: Maintenance of Oral Nutrition and Body Weight by Preserving Parotid Function. Am J Clin Oncol 2001 Aug;24(4):341-6.
Marks, J.E., Unpublished Data, 1989.
O’Sullivan, Brian, Lymphatic Metastases to the Un-irradiated Contralateral Side of the Neck in Patients with Squamous Cell Carcinoma of the Oral Cavity and Tonsil, Unpublished Data.
Chao KS, Deasy JO, Markman J, Perez CA, Purdy JA, Low DA. A prospective study of salivary function sparing in patients with head-and-neck cancers receiving intensity –modulated or three dimensional radiation therapy: Int J Radiat Oncol Biol Phys 2001 Mar 15;49(4): 907-16.
Hanson BS, Inglehart MR, Eisbruch A, Ship JA. Preserved salivary output and xerostomia-related quality of life in head and neck cancer patients receiving parotid-sparing radiotherapy. Oral Oncol 2001 Jan; 37(1):84-93.
Joseph R. Simposn and C.C. Wang: Principles and Practice of Radiation Oncology, 2nd ed, Fig. 30.8,30.10 and Fig.31.10. pp 662-3,683. Philadelphia, J.B. 1992.
Hazuka MB, Martel MK, Marsh L, Lichter AS, Wolf GT. Preservation of parotid function after external beam irradiation in head and neck cancer patients: a feasibility study using 3-dimensional treatment planing. Int J Radiat Oncol Biol Phys 1993 Oct. 20;27(3): 731-7.
Maes A, Weltens C, Flamen P, Lambin P, Bogaerts R, Liu X et al. Preservation of parotid function with uncomplicated conformal radiotherapy. Radiother Oncol 2002 May;63 (2): 203-11.
Carlos A. Perez. Tonsillar Fossa and Faucial Arch, Chapter 32, Eds. Carlos A. Perez and Luther W. Brady. Principles and Practice of Radiation Oncology 2nd ed. Fig. 32.4. pp. 693. and Fig. 33.2. pp. 715. Philadelphia J.B. Lippincott Raven, 1992.
Hameed S. and Marks JE. Parotid Sparing Radiation Techniques for Head and Neck Cancers. Syllabus for Head and Neck Rehabilitation International Conference and Work Shop. Dearborn, MI. March 14-18,1990
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.