Advanced TP

Parameters for clinical outcome: Salivary glands

Dose (Gy), or dose/volume parameters

Irradiation type (partial organ unless otherwise stated)

Volume segmented

Notes on dose/volume parameters

Endpoint

Rate (%)

Long term parotid salivary function reduced to <25% of pre- RT level Long term parotid salivary function reduced to <25% of pre- RT level Long term parotid salivary function reduced to <25% of pre- RT level

Bilateral whole parotid glands

For combined parotid glands

3D-CRT

Mean dose <25

<20

Unilateral whole parotid gland

For single parotid gland. At least one parotid gland spared to <20 Gy

3D-CRT

Mean dose <20

<20

Bilateral whole parotid glands For combined parotid glands • Severe xerostomia is related to additional factors including the doses to the submandibular glands • But submandibular glands should be included in the CTV for Ib nodes irradiation (oropharynx, oral cavity, N3) 3D-CRT Mean dose <39 <50

Deasy JO et al. Radiation Dose-Volume effects on the salivary gland function. Int. J. Radiation Oncology Biol. Phys., Vol. 76, No. 3, Supplement, pp. S58–S63, 2010.