Avoiding Radiation to Major Salivary Glands in Head and Neck Cancer Is Safe and Improves Quality of Life
New research is showing that sparing the contralateral submandibular gland during radiation therapy in the treatment of locally advanced head and neck cancer is technically feasible and safe even in advanced-stage, node-positive disease and base-of-tongue lesions. Limiting radiation to these major salivary glands was also found to improve patients’ quality of life. The study by Robin et al was presented at 2014 Multidisciplinary Head and Neck Cancer Symposium.
Study Details
Researchers conducted a retrospective analysis of 71 patients with advanced head and neck cancer who were treated with contralateral submandibular gland–sparing techniques. The median patient age was 55. About 50% of the patients were current or former smokers. Forty patients had primary tonsil cancers, 31 patients had tumors involving the base of the tongue, approximately 80% of the patients had N2b or greater disease, and 90% of patients had overall stage IV disease. The analysis was limited to patients who were receiving treatment to the bilateral neck.
Patients received a mean radiation dose of 33.04 Gy to the contralateral submandibular gland. At a median follow-up of 27.3 months, no patients had experienced recurrences in the contralateral level Ib lymph nodes.
“None of the patients had cancer recurrences in the spared area, and this really answers the main question,” Tyler Robin, PhD, lead author of the study and an MD candidate in his final year at the University of Colorado School of Medicine, said at a news briefing. “We showed that we were able to spare the gland, and we showed that it was safe.”
Improving Quality of Life
Sparing the submandibular gland from radiation, which produces the majority of unstimulated salivary production, can decrease the serious side effect of xerostomia. “It may sound trivial, but [xerostomia] actually has a significant impact on a patient’s quality of life. [Dry mouth] can affect a patient’s speech, swallowing, chewing, and eating,” said Dr. Robin. “Using modern radiation techniques, we’ve been able to shape radiation beams around the salivary glands while still treating a patient’s tumor.”
The study authors reported no potenitlal conflicts of interest.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
