title: Histopathological changes in parotid and submandibular glands of patients treated with preoperative chemoradiation therapy for oral cancer.
abstract: We retrospectively evaluated the relationship between computed tomography (CT)- and histopathological findings of parotid and submandibular glands in six patients treated for advanced oral cancer. Eligibility criteria were a pathologic diagnosis of oral squamous cell carcinoma, preoperative chemoradiation therapy (CRT) with a total dose of 30 Gy and oral S-1 (80 mg/m²/day), the availability of morphological assessments by CT and of functional assessments with the Saxon test before- and 2 weeks after CRT, and the availability of histopathological slides of irradiated parotid and submandibular glands. In the histopathological interpretation, gland structures were divided into acinar-, duct-, and adipose cells and other tissues. The Mann-Whitney test and the Spearman rank correlation test were used to determine histopathological changes. After 30-Gy irradiation, saliva production and parotid and submandibular volumes were significantly decreased (P < 0.05 each). Histopathological analysis demonstrated that 30-Gy irradiation resulted in a loss of acinar cells although acinar cells in the submandibular gland were relatively retained; the median acinar rate in the parotid and submandibular glands was 1.1% and 19.0%, respectively. The CT values after CRT were inversely correlated with adipose ratios (r = -0.98, P < 0.01) and there was a strong correlation between CT values before and after CRT (r = 0.97, P < 0.01). Our results suggested that acinar cell loss is a main contributor to changes in the volume and function of irradiated human parotid and submandibular glands. The CT value may reflect the adipose ratio rather than salivary function.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Teshima
authors.forename: Ryuji
authors.initials: R
authors.lastname: Murakami
authors.forename: Ryoji
authors.initials: R
authors.lastname: Yoshida
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakayama
authors.forename: Akimitsu
authors.initials: A
authors.lastname: Hiraki
authors.forename: Toshinori
authors.initials: T
authors.lastname: Hirai
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nakaguchi
authors.forename: Naoko
authors.initials: N
authors.lastname: Tsujita
authors.forename: Etsushi
authors.initials: E
authors.lastname: Tomitaka
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Furusawa
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Masanori
authors.initials: M
authors.lastname: Shinohara
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy*; D010094:Oxonic Acid / Q000008:administration & dosage; D010306:Parotid Gland / Q000187:drug effects / Q000473:pathology* / Q000528:radiation effects; D057234:Preoperative Period; D012189:Retrospective Studies; D012472:Salivation / Q000528:radiation effects; D013363:Submandibular Gland / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D005641:Tegafur / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid