Background/Objectives: We aimed to compare the salivary gland volume changes following intensity-modulated radiation therapy (IMRT) alone versus IMRT/intensity-modulated proton therapy (IMPT) combination in oropharyngeal cancer (OPC).Methods: We retrospectively reviewed 78 OPC patients who underwent definitive RT with ipsilateral neck irradiation. RT techniques were either IMRT alone or IMRT/IMPT combination. Salivary gland volumes over time in relation to dry mouth symptom were evaluated.Results: Patients’ characteristics were well balanced between groups. The mean dose to the ipsilateral parotid gland (PG) was significantly lower in IMRT alone than in IMRT/IMPT combination, while those to the contralateral PG and submandibular glands (SMGs) were significantly higher in IMRT alone. The volume ratio of ipsilateral PG showed an initial sharp decline, reaching 0.74, and stabilized thereafter. The ipsilateral SMG showed a continuous decline until 24 months and reached approximately 0.47 by 48 months. The contralateral PG/SMG showed initial decline and subsequent recovery to the initial volume by 48 months. There were no significant differences in salivary gland volume changes between groups. Within 6 months, 60.3% of patients experienced dry mouth symptom, and the dry mouth incidence decreased to 41.0% in 12 months and remained stable thereafter. There were no significant differences in dry mouth symptom between groups. The volume reduction in the ipsilateral salivary glands was greater in patients with dry mouth symptom.Conclusions: No significant differences in salivary gland volume changes and dry mouth symptom were apparent between groups. The critical factor in salivary gland volume change was the delivered dose to the salivary glands, not the RT techniques.
背景/目的：本研究旨在比较口咽癌患者接受单纯调强放射治疗与调强放疗/调强质子治疗联合治疗后唾液腺体积的变化差异。 方法：我们回顾性分析了78例接受根治性放疗（含同侧颈部照射）的口咽癌患者。放疗技术分为单纯调强放疗组与调强放疗/调强质子治疗联合组。评估了随时间推移的唾液腺体积变化及其与口干症状的关联。 结果：两组患者基线特征均衡。单纯调强放疗组同侧腮腺平均受照剂量显著低于联合治疗组，而对侧腮腺及颌下腺平均受照剂量显著高于联合治疗组。同侧腮腺体积比在初期急剧下降至0.74后趋于稳定；同侧颌下腺体积持续下降至24个月，至48个月时降至约0.47；对侧腮腺/颌下腺体积先下降后恢复，至48个月时基本恢复至初始体积。两组间唾液腺体积变化无显著差异。6个月内60.3%患者出现口干症状，12个月时降至41.0%并保持稳定，两组间口干症状发生率无显著差异。出现口干症状患者的同侧唾液腺体积减少更为显著。 结论：两组间唾液腺体积变化及口干症状均无显著差异。影响唾液腺体积变化的关键因素是腺体受照剂量，而非放疗技术类型。
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