title: Effect of Cisplatin on parotid gland function in concomitant radiochemotherapy.
abstract: OBJECTIVE
  To determine the influence of concomitant radiochemotherapy with cisplatin on parotid gland tissue complication probability.
  
  
  METHODS
  Patients treated with either radiotherapy (n = 61) or concomitant radiochemotherapy with cisplatin (n = 36) for head-and-neck cancer were prospectively evaluated. The dose and volume distributions of the parotid glands were noted in dose-volume histograms. Stimulated salivary flow rates were measured before, during the 2(nd) and 6(th) weeks and at 4 weeks and 6 months after the treatment. The data were fit using the normal tissue complication probability model of Lyman. Complication was defined as a reduction of the salivary flow rate to less than 25% of the pretreatment flow rate.
  
  
  RESULTS
  The normal tissue complication probability model parameter TD(50) (the dose leading to a complication probability of 50%) was found to be 32.2 Gy at 4 weeks and 32.1 Gy at 6 months for concomitant radiochemotherapy and 41.1 Gy at 4 weeks and 39.6 Gy at 6 months for radiotherapy. The tolerated dose for concomitant radiochemotherapy was at least 7 to 8 Gy lower than for radiotherapy alone at TD(50).
  
  
  CONCLUSIONS
  In this study, the concomitant radiochemotherapy tended to cause a higher probability of parotid gland tissue damage. Advanced radiotherapy planning approaches such as intensity-modulated radiotherapy may be particularly important for parotid sparing in radiochemotherapy because of cisplatin-related increased radiosensitivity of glands.
authors.affiliation: Department of Prosthetic Dentistry, University School of Dental Medicine, Martin- Luther- University, Halle, Germany.
authors.forename: Jeremias
authors.initials: J
authors.lastname: Hey
authors.forename: Jürgen
authors.initials: J
authors.lastname: Setz
authors.forename: Reinhard
authors.initials: R
authors.lastname: Gerlach
authors.forename: Dirk
authors.initials: D
authors.lastname: Vordermark
authors.forename: Christian R
authors.initials: CR
authors.lastname: Gernhardt
authors.forename: Thomas
authors.initials: T
authors.lastname: Kuhnt
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000503:physiopathology / Q000532:radiotherapy; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects*; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D019583:Dose Fractionation, Radiation; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000503:physiopathology / Q000532:radiotherapy; D006801:Humans; D007822:Laryngeal Neoplasms / Q000188:drug therapy / Q000503:physiopathology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009062:Mouth Neoplasms / Q000188:drug therapy / Q000503:physiopathology / Q000532:radiotherapy; D010306:Parotid Gland / Q000187:drug effects / Q000502:physiology / Q000528:radiation effects; D011446:Prospective Studies; D011832:Radiation Injuries / Q000139:chemically induced / Q000503:physiopathology; D011838:Radiation-Sensitizing Agents / Q000008:administration & dosage / Q000009:adverse effects*; D020266:Radiotherapy, Conformal / Q000009:adverse effects; D012472:Salivation / Q000187:drug effects* / Q000502:physiology / Q000528:radiation effects; D013997:Time Factors
chemical_list: D011838:Radiation-Sensitizing Agents; D002945:Cisplatin