期刊论文详细信息
Radiation Oncology
Clinical observation of submandibular gland transfer for the prevention of xerostomia after radiotherapy for nasopharyngeal carcinoma: a prospective randomized controlled study of 32 cases
Shaojin Li5  Fufu Xiao3  Xiuhong Wu1  Wei Wu1  Lijiang Yu4  Xiaolin Lan3  Folin Liu2  Xiangmin Zhang3 
[1] Department of Radiation Oncology, Tumor Hospital of Ganzhou, Ganzhou, Jiangxi Province, People’s Republic of China;First Affiliated Hospital of Gannan Medical University, Gannan, Jiangxi Province, People’s Republic of China;Department of Head and Neck, Tumor Hospital of Ganzhou, Ganzhou, Jiangxi Province, People’s Republic of China;Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China;Ganzhou Institute of Cancer Research, No. 19, HuaYuan Qian Road, Ganzhou 341000, Jiangxi Province, People’s Republic of China
关键词: Transfer;    Submandibular gland;    Xerostomia;    Radiotherapy;    Nasopharyngeal carcinoma;   
Others  :  828688
DOI  :  10.1186/1748-717X-9-62
 received in 2013-05-07, accepted in 2014-02-15,  发布年份 2014
PDF
【 摘 要 】

Background

The aim of this study was to evaluate the clinical efficacy of submandibular gland transfer for the prevention of xerostomia after radiotherapy for nasopharyngeal carcinoma.

Methods

Using the randomized controlled clinical research method, 65 patients with nasopharyngeal carcinoma were randomly divided into an experimental group consisting of 32 patients and a control group consisting of 33 patients. The submandibular glands were averted to the submental region in 32 patients with nasopharyngeal carcinoma before they received conventional radiotherapy; a lead block was used to shield the submental region during therapy. Prior to radiotherapy, the function of the submandibular glands was assessed using imaging. Submandibular gland function was measured using 99mTc radionuclide scanning at 60 months after radiotherapy. The data in the questionnaire regarding the degree of xerostomia were investigated and saliva secretion was measured at 3, 6, 12, and 60 months after radiotherapy. In addition, the 5-year survival rate was calculated.

Results

After follow-up for 3, 6, and 12 months, the incidence of moderate to severe xerostomia was significantly lower in the experimental group than in the control group. The average amount of saliva produced by the experimental and control groups was 1.60 g and 0.68 g, respectively (P < 0.001). After follow-up for 60 months, the uptake and secretion functions of the submandibular glands in the experimental group were found to be significantly higher than in the control group (P < 0.001 and P < 0.001, respectively). The incidence of moderate or severe xerostomia was significantly lower than in the control group (15.4% and 76.9%, respectively; P < 0.001). The 5-year survival rates of the experimental group and the control group were 81.3% and 78.8%, respectively, and there was no significant difference between the two groups (P = 0.806).

Conclusions

After a 5 year follow-up period involving 32 patients who had their submandibular glands transferred for the prevention of xerostomia after radiotherapy for nasopharyngeal carcinoma, we found that clinical efficacy was good. This approach could improve the quality of life of nasopharyngeal carcinoma patients after radiotherapy and would not affect long-term treatment efficacy.

【 授权许可】

   
2014 Zhang et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20140714025807145.pdf 3186KB PDF download
Figure 7. 50KB Image download
Figure 6. 39KB Image download
Figure 5. 41KB Image download
Figure 4. 113KB Image download
Figure 3. 123KB Image download
Figure 2. 49KB Image download
Figure 1. 80KB Image download
【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

Figure 6.

Figure 7.

【 参考文献 】
  • [1]Zimmerman RP, Mark RJ, Tran LM, Juillard GF: Concomitant pilocarpine during head and neck irradiation reduces xerostomia. Int J Radiat Oncol Biol Phys 1997, 37:571-575.
  • [2]Chao KS, Deasy JO, Markman J, Haynie 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: initial results. Int J Radiat Oncol Biol Phys 2001, 49:907-916.
  • [3]Antonadou D, Pepelassi M, Synodinou M, Puglisi M, Throuvalas N: prophylactic use of amifostine to prevent radiochemotherapy-induced mucositis and xerostomia in head-and-neck cancer. Int J Radiat Oncol Biol Phys 2002, 52:739-747.
  • [4]Jha N, Seikaly H, McGaw T, Coulter L: Submandibular salivary gland transfer prevents radiation induced xerostomia. Int J Radiat Oncol Biol Phys 2000, 46:7-11.
  • [5]Saibishkumar EP, Jha N, Scrimger RA, MacKenzie MA, Daly H, Field C, Fallone G, Parliament MB: Sparing the parotid glands and surgically transferred submandibular gland with helical tomotherapy in post-operative radiation of head and neck cancer: a planning study. Radiother Oncol 2007, 85:98-104.
  • [6]Jha N, Seikaly H, Harris J, Williams D, Sultanem K, Hier M, Ghosh S, Black M, Butler J, Sutherland D, Kerr P, Barnaby P: Phase III randomized study:oral pilocarpine versus submandibular salivary gland transfer protocol for the management of radiation-induced xerostomia. Head Neck 2009, 31:234-243.
  • [7]LeVeque FG, Montgomery M, Potter D, Zimmer MB, Rieke JW, Steiger BW, Gallagher SC, Muscoplat CC: A multicenter, randomized, double- blind, placebo-controlled, dose-titration study of oral pilocarpine for treatment of radiation-indueed xerostomia in head and neck cancer patients. J Clin Oncol 1993, 11:1124-1131.
  • [8]Klestov AC, Webb J, Latt D, Schiller G, McNamara K, Young DY, Hobbes J, Fetherston J: Treatment of xerostomia:a double-blind trial in 108 patients with sjögren,s syndrome. Oral Med 1981, 51:594-599.
  • [9]Cox JD, Stetz J, Pajak TF: Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys 1995, 31:1341-1346.
  • [10]Gresz V: Water-and electrolyte secretion by salivary glands. Orv Hetil 2006, 147:1891-1900.
  • [11]Wu Q, Manning M, Schmidt-Ullrich R, Mohan R: The potential for sparing of parotid and escalation of biologically effective dose with intensity-modulated radiation treatment of head and neck cancers;a treatment design study. Int J Radiat Oncol Biol Phys 2000, 46:195-205.
  • [12]Eisbruch A, Rhodus N, Rosenthal D, Murphy B, Rasch C, Sonis S, Scarantino C: Brizel D:How should we measure and report radiotherapy-induced xerostomia?Semin. Radiat Ocol 2003, 3:226-234.
  • [13]Jellema AP, Doornaert P, Slotman BJ, Leemans CR, Langendijk JA: Does radiation dose to the salivary glands and oral cavity predict patient-rated xerostomia and sticky saliva in head and neck cancer patients treated with curative radiotherapy? Radiother Oncol 2005, 77:164-171.
  • [14]Seikaly H, Jha N, McGaw T, Coulter L, Liu R, Oldring D: Submandibular gland transfer: a new method of preventing radiation-induced xerostomia. Laryngoscope 2001, 111:347-352.
  • [15]Wijers OB, Levendag PC, Braaksma MM, Boonzaaijer M, Visch LL, Schmitz PI: Patients with head and neck cancer cured by radiation therapy: a survey of the dry mouth syndrome in long-term survivors. Head Neck 2002, 24:737-747.
  • [16]Seikaly H, Jha N, Harris JR, Barnaby P, Liu R, Williams D, McGaw T, Rieger J, Wolfaardt J, Hanson J: Long-term outcomes of submandibular gland transfer for prevention of postradiation xerostomia. Arch Otolaryngol Head Neck Surg 2004, 130:956-961.
  • [17]Eisbruch A, Kim HM, Terrell JE, Marsh LH, Dawson LA, Ship JA: Xerostomia and its predictors following parotid-sparing irradiation of head-and-neck cancer. Int J Radiat Oncol Biol Phys 2001, 50:695-704.
  • [18]Eisbruch A: Radiotherapy:IMRT reduces xerostomia and potentially improves QoL. oncologyNat Rev Clin Oncol 2009, 6:567-568.
  • [19]Vergeer MR, Doornaert PA, Rietveld DH, Leemans CR, Slotman BJ, Langendijk JA: Intensity-modulated radiotherapy reduces radiation-induced morbidity and improves health-related quality of life:results of a nonrandomized prospective study using a standardized follow-up program. Int J Radiat Oncol Biol Phys 2009, 74:1-8.
  文献评价指标  
  下载次数:71次 浏览次数:40次