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Updated: May 31, 2026
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Retroductal Submandibular Gland Instillation and Localized Fractionated Irradiation in a Rat Model of Salivary Hypofunction
Published on: April 24, 2016
Sparing the contralateral submandibular gland without compromising PTV coverage by using volumetric modulated arc
Patricia Doornaert1, Wilko F A R Verbakel, Derek H F Rietveld
1Department of Radiation Oncology, VU University Medical Center, PB 7057, 1007 MB Amsterdam, The Netherlands. p.doornaert@vumc.nl
Radiation Oncology (London, England)
|June 18, 2011
Summary
This study shows that sparing contralateral submandibular glands (CLSM) during head and neck cancer radiotherapy is feasible. The technique successfully reduced radiation dose to CLSM without affecting tumor coverage.
Area of Science:
- Radiation Oncology
- Head and Neck Cancer Treatment
- Salivary Gland Preservation
Background:
- Salivary gland function is impaired by radiation doses of 39 Gy or higher.
- Submandibular glands are typically not spared during elective neck irradiation.
- A novel technique was developed to spare contralateral submandibular glands (CLSM).
Purpose of the Study:
- To evaluate the efficacy of a technique for sparing CLSM during contralateral elective neck irradiation.
- To assess if CLSM sparing compromises planning target volume (PTV) coverage.
- To determine the dose reduction achieved for CLSM.
Main Methods:
- Volumetric modulated arc therapy (RapidArc™) was used in 31 head and neck cancer patients.
- Patients received elective treatment to contralateral nodal levels II-IV.
- Clinical plans incorporated CLSM sparing constraints; a non-sparing plan was retrospectively generated for comparison.
Main Results:
- PTV coverage remained consistent between sparing and non-sparing plans.
- Mean CLSM dose was significantly reduced in sparing plans (33.2 Gy vs. 50.6 Gy in Group 1; 34.4 Gy vs. 46.8 Gy in Group 2).
- The technique consistently kept CLSM doses below the 39 Gy threshold for salivary gland dysfunction.
Conclusions:
- Elective radiotherapy to contralateral nodal levels II-IV using RapidArc effectively spares CLSM.
- This technique limits CLSM doses below 39 Gy without compromising PTV coverage.
- Further research is needed to determine if this dose reduction alleviates patient symptoms.
