The effect of parotid gland‐sparing intensity‐modulated radiotherapy on salivary composition, flow rate and xerostomia measures
Objectives To describe parotid gland (PG) saliva organic and inorganic composition and flow rate changes, after curative intensity‐modulated radiotherapy (IMRT) for head and neck cancer (HNC), and analyse the relationship between PG saliva analytes and xerostomia measures. Methods and Materials Twen...
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| Veröffentlicht in: | Oral diseases 2017-10, Vol.23 (7), p.990-1000 |
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| creator | Richards, TM Hurley, T Grove, L Harrington, KJ Carpenter, GH Proctor, GB Nutting, CM |
| description | Objectives
To describe parotid gland (PG) saliva organic and inorganic composition and flow rate changes, after curative intensity‐modulated radiotherapy (IMRT) for head and neck cancer (HNC), and analyse the relationship between PG saliva analytes and xerostomia measures.
Methods and Materials
Twenty‐six patients recruited to five prospective phase 2 or 3 trials which assessed toxicity and efficacy of IMRT by HNC subsite, provided longitudinal PG saliva. Salivary flow rate, and subjective and objective xerostomia measures were prospectively collected and saliva tested for inorganic and organic analytes. Statistical comparisons of longitudinal analyte changes and analysis for a relationship between dichotomized xerostomia score and saliva analytes were performed.
Results
One hundred and forty‐two PG saliva samples from 26 patients were analysed. At 3–6 months after IMRT, stimulated and unstimulated saliva showed significantly decreased flow rate, total protein (TP) secretion rate, phosphate concentration and increased lactoferrin (LF) concentration. Stimulated saliva alone had elevated LF secretion rate and beta‐2‐microglobulin (B2M) concentration with decreased calcium (Ca2+) and magnesium (Mg2+) concentrations and Ca2+ secretion rate. At >12 months, under stimulated and unstimulated conditions, increased LF concentration and decreased Mg2+ and phosphate concentration persisted and, in stimulated saliva, there was decreased potassium (K+) and Mg2+ concentration. Unstimulated TP secretion rate was lower in the presence of high‐grade xerostomia. Otherwise, no relationship between xerostomia grade and PG salivary flow rate, TP and Ca2+ secretion rate was found.
Conclusion
Fewer significant differences in PG saliva analytes >12 months after IMRT indicate good functional recovery. Residual xerostomia after IMRT will only be further reduced by addressing the sparing of subsites of the PG or other salivary gland tissues, in addition to the PG. |
| doi_str_mv | 10.1111/odi.12686 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_1936534600</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1936534600</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3886-e3e03d00218f85e6a18a3bc79cf199c7ade0c65e1c1e748653039279c0c290993</originalsourceid><addsrcrecordid>eNp1kM9KxDAQh4Mo7rp68AUk4EmwmjRtNznK-heEvSh4K9lkumZpm5qkrnsTfAGf0ScxuurNXBImH9_M_BDap-SExnNqtTmhacGLDTSkBaEJ4Wm-Gd8sz5I8ZQ8DtOP9ghA6FizdRoOUZyyjgg7R290jYKgqUAHbCnfS2WA0ntey1R-v7z4WTDvHpg3QehNWsdZY3dcygMZOamPDIzjZrbBtsZe1eZZuhZVtOhtxY9tjXNV2GdEAODrxCzjrg22MxA1I3zvwu2irkrWHvZ97hO4vL-4m18nt9OpmcnabKMZ5kQADwjQhKeUVz6GQlEs2U2OhKiqEGksNRBU5UEVhnPEiZ4SJNH4TlQoiBBuhw7W3c_apBx_Khe1dG1uWVLDIZwUhkTpaUyoO6h1UZedME7cqKSm_4i5j3OV33JE9-DH2swb0H_mbbwRO18DS1LD631ROz2_Wyk9ZoY25</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1936534600</pqid></control><display><type>article</type><title>The effect of parotid gland‐sparing intensity‐modulated radiotherapy on salivary composition, flow rate and xerostomia measures</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Richards, TM ; Hurley, T ; Grove, L ; Harrington, KJ ; Carpenter, GH ; Proctor, GB ; Nutting, CM</creator><creatorcontrib>Richards, TM ; Hurley, T ; Grove, L ; Harrington, KJ ; Carpenter, GH ; Proctor, GB ; Nutting, CM</creatorcontrib><description>Objectives
To describe parotid gland (PG) saliva organic and inorganic composition and flow rate changes, after curative intensity‐modulated radiotherapy (IMRT) for head and neck cancer (HNC), and analyse the relationship between PG saliva analytes and xerostomia measures.
Methods and Materials
Twenty‐six patients recruited to five prospective phase 2 or 3 trials which assessed toxicity and efficacy of IMRT by HNC subsite, provided longitudinal PG saliva. Salivary flow rate, and subjective and objective xerostomia measures were prospectively collected and saliva tested for inorganic and organic analytes. Statistical comparisons of longitudinal analyte changes and analysis for a relationship between dichotomized xerostomia score and saliva analytes were performed.
Results
One hundred and forty‐two PG saliva samples from 26 patients were analysed. At 3–6 months after IMRT, stimulated and unstimulated saliva showed significantly decreased flow rate, total protein (TP) secretion rate, phosphate concentration and increased lactoferrin (LF) concentration. Stimulated saliva alone had elevated LF secretion rate and beta‐2‐microglobulin (B2M) concentration with decreased calcium (Ca2+) and magnesium (Mg2+) concentrations and Ca2+ secretion rate. At >12 months, under stimulated and unstimulated conditions, increased LF concentration and decreased Mg2+ and phosphate concentration persisted and, in stimulated saliva, there was decreased potassium (K+) and Mg2+ concentration. Unstimulated TP secretion rate was lower in the presence of high‐grade xerostomia. Otherwise, no relationship between xerostomia grade and PG salivary flow rate, TP and Ca2+ secretion rate was found.
Conclusion
Fewer significant differences in PG saliva analytes >12 months after IMRT indicate good functional recovery. Residual xerostomia after IMRT will only be further reduced by addressing the sparing of subsites of the PG or other salivary gland tissues, in addition to the PG.</description><identifier>ISSN: 1354-523X</identifier><identifier>EISSN: 1601-0825</identifier><identifier>DOI: 10.1111/odi.12686</identifier><identifier>PMID: 28434191</identifier><language>eng</language><publisher>Denmark: Wiley Subscription Services, Inc</publisher><subject>Adult ; Aged ; Calcium ; Cancer ; Clinical trials ; Clinical Trials, Phase II as Topic ; Clinical Trials, Phase III as Topic ; Exocrine glands ; Female ; Head & neck cancer ; head and neck cancer ; Head and Neck Neoplasms - radiotherapy ; Humans ; IMRT ; Lactoferrin ; Magnesium ; Male ; Middle Aged ; Organ Sparing Treatments ; Organs at Risk ; Parotid gland ; Parotid Gland - radiation effects ; Radiation Dosage ; Radiation therapy ; radiotherapy ; Radiotherapy, Intensity-Modulated - adverse effects ; Radiotherapy, Intensity-Modulated - methods ; Recovery of function ; Saliva ; Saliva - chemistry ; Saliva - metabolism ; Saliva - radiation effects ; Salivary gland ; Secretion ; Toxicity ; Xerostomia ; Xerostomia - etiology</subject><ispartof>Oral diseases, 2017-10, Vol.23 (7), p.990-1000</ispartof><rights>2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved</rights><rights>2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved.</rights><rights>Copyright © 2017 John Wiley & Sons A/S</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3886-e3e03d00218f85e6a18a3bc79cf199c7ade0c65e1c1e748653039279c0c290993</citedby><cites>FETCH-LOGICAL-c3886-e3e03d00218f85e6a18a3bc79cf199c7ade0c65e1c1e748653039279c0c290993</cites><orcidid>0000-0002-2054-9311</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fodi.12686$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fodi.12686$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28434191$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Richards, TM</creatorcontrib><creatorcontrib>Hurley, T</creatorcontrib><creatorcontrib>Grove, L</creatorcontrib><creatorcontrib>Harrington, KJ</creatorcontrib><creatorcontrib>Carpenter, GH</creatorcontrib><creatorcontrib>Proctor, GB</creatorcontrib><creatorcontrib>Nutting, CM</creatorcontrib><title>The effect of parotid gland‐sparing intensity‐modulated radiotherapy on salivary composition, flow rate and xerostomia measures</title><title>Oral diseases</title><addtitle>Oral Dis</addtitle><description>Objectives
To describe parotid gland (PG) saliva organic and inorganic composition and flow rate changes, after curative intensity‐modulated radiotherapy (IMRT) for head and neck cancer (HNC), and analyse the relationship between PG saliva analytes and xerostomia measures.
Methods and Materials
Twenty‐six patients recruited to five prospective phase 2 or 3 trials which assessed toxicity and efficacy of IMRT by HNC subsite, provided longitudinal PG saliva. Salivary flow rate, and subjective and objective xerostomia measures were prospectively collected and saliva tested for inorganic and organic analytes. Statistical comparisons of longitudinal analyte changes and analysis for a relationship between dichotomized xerostomia score and saliva analytes were performed.
Results
One hundred and forty‐two PG saliva samples from 26 patients were analysed. At 3–6 months after IMRT, stimulated and unstimulated saliva showed significantly decreased flow rate, total protein (TP) secretion rate, phosphate concentration and increased lactoferrin (LF) concentration. Stimulated saliva alone had elevated LF secretion rate and beta‐2‐microglobulin (B2M) concentration with decreased calcium (Ca2+) and magnesium (Mg2+) concentrations and Ca2+ secretion rate. At >12 months, under stimulated and unstimulated conditions, increased LF concentration and decreased Mg2+ and phosphate concentration persisted and, in stimulated saliva, there was decreased potassium (K+) and Mg2+ concentration. Unstimulated TP secretion rate was lower in the presence of high‐grade xerostomia. Otherwise, no relationship between xerostomia grade and PG salivary flow rate, TP and Ca2+ secretion rate was found.
Conclusion
Fewer significant differences in PG saliva analytes >12 months after IMRT indicate good functional recovery. Residual xerostomia after IMRT will only be further reduced by addressing the sparing of subsites of the PG or other salivary gland tissues, in addition to the PG.</description><subject>Adult</subject><subject>Aged</subject><subject>Calcium</subject><subject>Cancer</subject><subject>Clinical trials</subject><subject>Clinical Trials, Phase II as Topic</subject><subject>Clinical Trials, Phase III as Topic</subject><subject>Exocrine glands</subject><subject>Female</subject><subject>Head & neck cancer</subject><subject>head and neck cancer</subject><subject>Head and Neck Neoplasms - radiotherapy</subject><subject>Humans</subject><subject>IMRT</subject><subject>Lactoferrin</subject><subject>Magnesium</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Organ Sparing Treatments</subject><subject>Organs at Risk</subject><subject>Parotid gland</subject><subject>Parotid Gland - radiation effects</subject><subject>Radiation Dosage</subject><subject>Radiation therapy</subject><subject>radiotherapy</subject><subject>Radiotherapy, Intensity-Modulated - adverse effects</subject><subject>Radiotherapy, Intensity-Modulated - methods</subject><subject>Recovery of function</subject><subject>Saliva</subject><subject>Saliva - chemistry</subject><subject>Saliva - metabolism</subject><subject>Saliva - radiation effects</subject><subject>Salivary gland</subject><subject>Secretion</subject><subject>Toxicity</subject><subject>Xerostomia</subject><subject>Xerostomia - etiology</subject><issn>1354-523X</issn><issn>1601-0825</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM9KxDAQh4Mo7rp68AUk4EmwmjRtNznK-heEvSh4K9lkumZpm5qkrnsTfAGf0ScxuurNXBImH9_M_BDap-SExnNqtTmhacGLDTSkBaEJ4Wm-Gd8sz5I8ZQ8DtOP9ghA6FizdRoOUZyyjgg7R290jYKgqUAHbCnfS2WA0ntey1R-v7z4WTDvHpg3QehNWsdZY3dcygMZOamPDIzjZrbBtsZe1eZZuhZVtOhtxY9tjXNV2GdEAODrxCzjrg22MxA1I3zvwu2irkrWHvZ97hO4vL-4m18nt9OpmcnabKMZ5kQADwjQhKeUVz6GQlEs2U2OhKiqEGksNRBU5UEVhnPEiZ4SJNH4TlQoiBBuhw7W3c_apBx_Khe1dG1uWVLDIZwUhkTpaUyoO6h1UZedME7cqKSm_4i5j3OV33JE9-DH2swb0H_mbbwRO18DS1LD631ROz2_Wyk9ZoY25</recordid><startdate>201710</startdate><enddate>201710</enddate><creator>Richards, TM</creator><creator>Hurley, T</creator><creator>Grove, L</creator><creator>Harrington, KJ</creator><creator>Carpenter, GH</creator><creator>Proctor, GB</creator><creator>Nutting, CM</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><orcidid>https://orcid.org/0000-0002-2054-9311</orcidid></search><sort><creationdate>201710</creationdate><title>The effect of parotid gland‐sparing intensity‐modulated radiotherapy on salivary composition, flow rate and xerostomia measures</title><author>Richards, TM ; Hurley, T ; Grove, L ; Harrington, KJ ; Carpenter, GH ; Proctor, GB ; Nutting, CM</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3886-e3e03d00218f85e6a18a3bc79cf199c7ade0c65e1c1e748653039279c0c290993</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Calcium</topic><topic>Cancer</topic><topic>Clinical trials</topic><topic>Clinical Trials, Phase II as Topic</topic><topic>Clinical Trials, Phase III as Topic</topic><topic>Exocrine glands</topic><topic>Female</topic><topic>Head & neck cancer</topic><topic>head and neck cancer</topic><topic>Head and Neck Neoplasms - radiotherapy</topic><topic>Humans</topic><topic>IMRT</topic><topic>Lactoferrin</topic><topic>Magnesium</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Organ Sparing Treatments</topic><topic>Organs at Risk</topic><topic>Parotid gland</topic><topic>Parotid Gland - radiation effects</topic><topic>Radiation Dosage</topic><topic>Radiation therapy</topic><topic>radiotherapy</topic><topic>Radiotherapy, Intensity-Modulated - adverse effects</topic><topic>Radiotherapy, Intensity-Modulated - methods</topic><topic>Recovery of function</topic><topic>Saliva</topic><topic>Saliva - chemistry</topic><topic>Saliva - metabolism</topic><topic>Saliva - radiation effects</topic><topic>Salivary gland</topic><topic>Secretion</topic><topic>Toxicity</topic><topic>Xerostomia</topic><topic>Xerostomia - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Richards, TM</creatorcontrib><creatorcontrib>Hurley, T</creatorcontrib><creatorcontrib>Grove, L</creatorcontrib><creatorcontrib>Harrington, KJ</creatorcontrib><creatorcontrib>Carpenter, GH</creatorcontrib><creatorcontrib>Proctor, GB</creatorcontrib><creatorcontrib>Nutting, CM</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Oral diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Richards, TM</au><au>Hurley, T</au><au>Grove, L</au><au>Harrington, KJ</au><au>Carpenter, GH</au><au>Proctor, GB</au><au>Nutting, CM</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effect of parotid gland‐sparing intensity‐modulated radiotherapy on salivary composition, flow rate and xerostomia measures</atitle><jtitle>Oral diseases</jtitle><addtitle>Oral Dis</addtitle><date>2017-10</date><risdate>2017</risdate><volume>23</volume><issue>7</issue><spage>990</spage><epage>1000</epage><pages>990-1000</pages><issn>1354-523X</issn><eissn>1601-0825</eissn><abstract>Objectives
To describe parotid gland (PG) saliva organic and inorganic composition and flow rate changes, after curative intensity‐modulated radiotherapy (IMRT) for head and neck cancer (HNC), and analyse the relationship between PG saliva analytes and xerostomia measures.
Methods and Materials
Twenty‐six patients recruited to five prospective phase 2 or 3 trials which assessed toxicity and efficacy of IMRT by HNC subsite, provided longitudinal PG saliva. Salivary flow rate, and subjective and objective xerostomia measures were prospectively collected and saliva tested for inorganic and organic analytes. Statistical comparisons of longitudinal analyte changes and analysis for a relationship between dichotomized xerostomia score and saliva analytes were performed.
Results
One hundred and forty‐two PG saliva samples from 26 patients were analysed. At 3–6 months after IMRT, stimulated and unstimulated saliva showed significantly decreased flow rate, total protein (TP) secretion rate, phosphate concentration and increased lactoferrin (LF) concentration. Stimulated saliva alone had elevated LF secretion rate and beta‐2‐microglobulin (B2M) concentration with decreased calcium (Ca2+) and magnesium (Mg2+) concentrations and Ca2+ secretion rate. At >12 months, under stimulated and unstimulated conditions, increased LF concentration and decreased Mg2+ and phosphate concentration persisted and, in stimulated saliva, there was decreased potassium (K+) and Mg2+ concentration. Unstimulated TP secretion rate was lower in the presence of high‐grade xerostomia. Otherwise, no relationship between xerostomia grade and PG salivary flow rate, TP and Ca2+ secretion rate was found.
Conclusion
Fewer significant differences in PG saliva analytes >12 months after IMRT indicate good functional recovery. Residual xerostomia after IMRT will only be further reduced by addressing the sparing of subsites of the PG or other salivary gland tissues, in addition to the PG.</abstract><cop>Denmark</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28434191</pmid><doi>10.1111/odi.12686</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-2054-9311</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Calcium Cancer Clinical trials Clinical Trials, Phase II as Topic Clinical Trials, Phase III as Topic Exocrine glands Female Head & neck cancer head and neck cancer Head and Neck Neoplasms - radiotherapy Humans IMRT Lactoferrin Magnesium Male Middle Aged Organ Sparing Treatments Organs at Risk Parotid gland Parotid Gland - radiation effects Radiation Dosage Radiation therapy radiotherapy Radiotherapy, Intensity-Modulated - adverse effects Radiotherapy, Intensity-Modulated - methods Recovery of function Saliva Saliva - chemistry Saliva - metabolism Saliva - radiation effects Salivary gland Secretion Toxicity Xerostomia Xerostomia - etiology |
| title | The effect of parotid gland‐sparing intensity‐modulated radiotherapy on salivary composition, flow rate and xerostomia measures |
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