Zhou Xiang,Zhang Shuxu,Wang Ruihao,Lin Shengqu,Jiang Shaohui,Lei Huaiyu,Zhang Guoqian,Zhou Lu,Deng Jin.Correlation between the reduction of parotid gland and gross tumor volume and their exposure dose in patients with different metastasis status of lymph node receiving intensity-modulated radiotherapy for nasopharyngeal carcinoma[J].Chinese Journal of Radiological Medicine and Protection,2016,36(2):111-115
Correlation between the reduction of parotid gland and gross tumor volume and their exposure dose in patients with different metastasis status of lymph node receiving intensity-modulated radiotherapy for nasopharyngeal carcinoma
Received:September 22, 2015  
DOI:10.3760/cma.j.issn.0254-5098.2016.02.006
KeyWords:Nasopharyngeal carcinoma  Volume change  IMRT  Lymph node diameter
FundProject:广东省教育厅特色创新项目(2014KTSCX104);广东省科技计划项目(2013B021800274);广东省教育厅科技创新项目(2013KJCX0152)
Author NameAffiliationE-mail
Zhou Xiang Department of Radiotherapy, Affiliated Tumor Hospital of Guangzhou Medical University, Guangzhou 510095, China  
Zhang Shuxu Department of Radiotherapy, Affiliated Tumor Hospital of Guangzhou Medical University, Guangzhou 510095, China gthzsx@163.com 
Wang Ruihao Department of Radiotherapy, Affiliated Tumor Hospital of Guangzhou Medical University, Guangzhou 510095, China  
Lin Shengqu Department of Radiotherapy, Affiliated Tumor Hospital of Guangzhou Medical University, Guangzhou 510095, China  
Jiang Shaohui Department of Radiotherapy, Affiliated Tumor Hospital of Guangzhou Medical University, Guangzhou 510095, China  
Lei Huaiyu Department of Radiotherapy, Affiliated Tumor Hospital of Guangzhou Medical University, Guangzhou 510095, China  
Zhang Guoqian Department of Radiotherapy, Affiliated Tumor Hospital of Guangzhou Medical University, Guangzhou 510095, China  
Zhou Lu Department of Radiotherapy, Affiliated Tumor Hospital of Guangzhou Medical University, Guangzhou 510095, China  
Deng Jin Department of Radiotherapy, Affiliated Tumor Hospital of Guangzhou Medical University, Guangzhou 510095, China  
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Abstract::
      Objective The aim of this study was to explore the correlation between the reduction of parotid gland and gross tumor volume and their exposure dose in patients with different metastasis status of lymph node receiving intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma, and to determine the best time for replanning. Methods Thirty patients with NPC treated with IMRT were divided into three groups according to lymph node diameter: lymph-node negative (group A), lymph-node positive and diameter≤3 cm (group B), and diameter >3 cm (group C). The initial computed tomography (CT) scan was CT0. Each patient was rescanned weekly in the same position at the 5th, 10th, 15th, 20th, 25th and 32nd fraction (CT1, CT2, CT3, CT4, CT5 and CT6, respectively). Results CT0 showed no difference in initial parotid volumes among the three groups (P>0.05). Between-group analysis showed a significant difference in parotid volume changes after CT4 between group A and B (t=2.12-2.46, P<0.05) and between group A and C after CT3 (t=2.19-3.25, P<0.05). According to within-group analysis, significant parotid volume changes occurred in groups A and B after CT3 (t=2.16-4.11, P<0.05) and in group C after CT2 (t=2.37-5.20, P<0.05), compared with CT0. There were significant changes when CT4 compared with CT2 (t=2.16, 3.34, P<0.05) in groups C. ConclusionsPatients with larger lymph nodes need earlier replanning of IMRT, at the 10th and possibly again at the 20th fraction, while patients with negative or smaller lymph nodes do not require replanning until the 15th fraction.
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