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INTERNATIONAL JOURNAL OF SCIENTIFIC DEVELOPMENT AND RESEARCH International Peer Reviewed & Refereed Journals, Open Access Journal ISSN Approved Journal No: 2455-2631 | Impact factor: 8.15 | ESTD Year: 2016 open access , Peer-reviewed, and Refereed Journals, Impact factor 8.15 |
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| Paper Title: | SINGLE INSTITUTE BASED PROSPECTIVE RANDOMISED STUDY ON THE EFFECT OF PAROTID STEM CELL SPARING IMRT IN HEAD AND NECK CANCER |
| Authors Name: | DR LEKSHMI THILAK |
| Unique Id: | IJSDR2306134 |
| Published In: | Volume 8 Issue 6, June-2023 |
| Abstract: | ABSTRACT AIM: Our study aims at analysing the concept of preserving the function of parotid gland more efficiently when stem cell region of parotid gland is spared. OBJECTIVES: The primary objective was to test the hypothesis that if stem cell region of parotid is spared, it better preserves parotid gland function by using EORTC QLQ H&N- 35. The secondary objectives were 1) To assess the patient rated day and night time xerostomia between two arms subjectively by using Groningen Radiation induced Xerostomia Questionnaire ,2) To compare the mean dose to the both parotids, both superficial lobes, both deep lobes and both stem cell region between the arms. METHODS: Prospective randomized study done in 100 patients of head and neck cancer. Patients with diagnosis of head and neck carcinoma with confirmed histology of squamous cell carcinoma, undergoing definitive radiotherapy treatment with bilateral cervical nodal irradiation with concurrent chemotherapy with Cisplatin are included. All the 100 patients were randomized to two groups: whole parotid sparing without stem cell sparing or whole parotid sparing with parotid stem cell sparing group. Then patients were routinely followed up for grading the symptoms of Xerostomia/ Dry Mouth, which was done subjectively by using EORTC QLQ H& N 35 and Groningen Radiation Induced Xerostomia Questionnaire before starting RT, on completing RT, at 3 months and 6months post completion of RT. INTRODUCTION: Xerostomia is the very common and irreversible side effect of radiotherapy to head and neck cancer.The concept of IMRT then came up with main rationale to reduce radiation dose to the whole parotid gland there by reducing xerostomia. But modern studies emerged with the concept that around the main salivary ducts of parotid where the first branch of stensen ducts arises, stem cell/progenitor cells are resided. This is suggested by the data from irradiated rats and human parotid gland. In order gain higher salivary output and further reduction in xerostomia, efforts were made to spare this specific region using IMRT. RESULTS: A significant p value <0.0001 was found for the difference in mean dose to bilateral whole parotid and mean dose to bilateral stem cell between study arm and control arm. No patients had dry mouth before starting radiotherapy. There is no statistically significant difference reported in experiencing dry mouth after completing radiotherapy, at 3month post radiotherapy and 6month post radiotherapy when comparing study arm and control arm. Even for dry mouth in day time or night time, there was no significant difference shown. CONCLUSION: Dose to parotid and parotid stem cell region will be one of these factors that affects xerostomia. The effect of submandibular gland dose and dose to other OARs such as oral cavity (where the sublingual and minor salivary glands reside) on xerostomia were shown by some studies. But these factors were not analysed and assessed in our study. So the concept of parotid stem cell sparing rather than whole parotid sparing alone is not proven to be promising in preserving salivary gland function from our study. |
| Keywords: | Key words: Head and neck cancer, Xerostomia, Parotid, Parotid stem cell region, c Kit + cells |
| Cite Article: | "SINGLE INSTITUTE BASED PROSPECTIVE RANDOMISED STUDY ON THE EFFECT OF PAROTID STEM CELL SPARING IMRT IN HEAD AND NECK CANCER", International Journal of Science & Engineering Development Research (www.ijsdr.org), ISSN:2455-2631, Vol.8, Issue 6, page no.942 - 949, June-2023, Available :http://www.ijsdr.org/papers/IJSDR2306134.pdf |
| Downloads: | 000337351 |
| Publication Details: | Published Paper ID: IJSDR2306134 Registration ID:203783 Published In: Volume 8 Issue 6, June-2023 DOI (Digital Object Identifier): Page No: 942 - 949 Publisher: IJSDR | www.ijsdr.org ISSN Number: 2455-2631 |
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