Table 2.
Published studies with either IMRT or conventional techniques. Data included concomitant chemotherapy or not, follow-up, and radiation-induced toxicity.
| Study | Radiation treatment |
Concurrent chemotherapy No. of patients (%) |
Median followup (range) |
Toxicity (≥GrII) | Mean parotid- gland dose | |||
|---|---|---|---|---|---|---|---|---|
| Mucositis | Xerostomia | |||||||
| Acute | Late | Acute | Late | |||||
| Studer et al. [24]† | IMRT | Yes (86%) | 16 mths (4–44 mths) | 65% | — | — | — | |
| Lee et al. [8] | IMRT | Yes | 31 mths (20–64 mths) | 66% | — | 66% | 12% | |
| 2DRT | Yes | 46 mths (3–93 mths) | 72% | 65% | 67% | |||
| Garden et al. [25] | IMRT | Yes (8%) | 45 mths (15–63 mths) | — | — | — | — | 23.9 Gy |
| Daly et al. [26]† | IMRT | Yes (87%) | 29 mths (4–105 mths) | 93% | — | — | — | 33.2 Gy |
| Chao et al. [27]† | IMRT | Yes (23%) | 33 mths (9–60 mths) | 86% | — | — | 12% | 18.6 Gy |
| Huang et al. [28] | IMRT | Yes | 33 mths (3–72 mths) | 92% | — | — | 34% | 25.5 Gy |
| Setton et al. [29]† | IMRT | Yes (88%) | 36.8 mths (3–135 mths) | 68% | — | 28% | 29% | 25.8 Gy |
| Kwong et al. [34] | IMRT | No | 24 mths (11–42 mths) | 82% | — | — | 40% (1yrs) 15% (2yrs) | 38.8 Gy |
| Wolden et al. [35] | IMRT | Yes (93%) | 35 mths (3–74 mths) | 32% (1yrs) | 35.2 Gy | |||
| Kam et al. [36] | IMRT | Yes (30%) | 29 mths (8–45 mths) | 92% | 75% | 23% (2yrs) | 39 Gy | |
| 16.7% (2yrs) | 31 Gy | |||||||
| Lee et al. [38] | IMRT | Yes (65%) | 31 mths (6–55 mths) | — | 22% | — | 33% | |
| Lee et al. [40] | IMRT | Yes (75%) | 31 mths (7–72 mths) | 94% | — | 58% | ||
| Liu et al. [41] | IMRT | Yes (58%) | 13.0 mths (8–18 mths) | — | 79% | — | 53% | 37.8 Gy |
| Luo et al. [42] | 3D-CRT | No | 58 mths (25–92 mths) | 74% | 12% | 12% | 52.8 Gy | |
| Al-Mamgani et al. [47] |
IMRT + 3D-CRT | Yes(28.3%) | 32 mths (7–172 mths) | 14.1% | 23.6 Gy | |||
| Lee et al. [50] | IMRT | Yes (65%) | 26 mths (17–58 mths) | 48% | 3.2% | 26 Gy | ||
| Van Gestel et al. [51]† | IMRT | Yes Def: 63% Post: 23% |
18.7 mths (0.13–51.7 mths) | 100% | 44% | |||
| Peponi et al. [52]† | IMRT | Yes (85%) | 55 mths | Obj: 7.3 % Sub: 3.6% | ||||
| Gupta et al. [23] | 3D-CRT | Yes | 40 mths (26–50 mths) | 93% | 53 Gy | |||
| IMRT | Yes (90%) | 40 mths (26–50 mths) | 77% | 34.3 Gy | ||||
| Lambrecht et al. [18] | 3D-CRT | Yes (80%) | 68 mths (37.2–104 mths) | 44% | 68% | 53 Gy | ||
| IMRT | Yes (81%) | 35 mths (4.7–63.5 mths) | 32% | 23% | 34 Gy | |||
| Toledano et al. [53]† | IMRT | Yes (37.5%) | 25.3 mths (0.4–72 mths) | ~73% | — | — | ~58% | |
| Clavel et al. [9] | IMRT | Yes | 42 mths | 75% | 8% (2yrs) | |||
| 2-3DRT | Yes | 42 mths | 77% | 74% (2yrs) | ||||
| Vergeer et al. [20]† | IMRT | Yes (43%) | — | 32% (6 mths) | 27 Gy | |||
| 3D-CRT | Yes (35%) | — | 56% (6 mths) | 43 Gy | ||||
| Chen et al. [21]* | IMRT | Yes (9%) | 44 mths | 87% | 36% | |||
| 3D-CRT | Yes (2%) | 44 mths | 89% | 82% | ||||
| Nutting et al. [12]† | IMRT | Yes (43%) | 44 mths | 93% | 71% | 69% | 36.5 Gy | |
| 3D-CRT | Yes (40%) | 44 mths | 94% | 91% | 76% | 61 Gy | ||
| Wong et al. [33] | IMRT | Yes (70%) | 34 mths (9–50 mths) | 67.4% | 2.3% | 30 Gy | ||
| Sultanem et al. [44] | IMRT | Yes (91%) | 21.8 mths (5–49 mths) | 97% | 28% | |||
| Su et al. [45] | IMRT | No | 50.9 mths (12–104 mths) | 73% | 36% | 15.4% (1yrs) 9.0% (2yrs) | 31 Gy | |
| Wang et al. [43] | IMRT | Yes (83%) | 47.1 mths (11–68 mths) | 33.3% | 4.7% | 12.3% (2yrs) | 27.6 Gy | |
| Rades et al. [22]* | 2DRT | Yes (8%) | ~90% | 73% | ||||
| 3D-CRT | Yes (23%) | ~90% | 63% | |||||
| IMRT | Yes (6%) | ~90% | 17% | |||||
| Tham et al. [39] | IMRT | Yes | 36.5 mths | 29% (Gr3) | 3% (Gr3) | |||
| IMRT | No | 36.5 mths | 20% (Gr3) | |||||
| Kim et al. [46] | 3D-CRT | No | 48 mths | 57% | 19% | |||
| De Arruda et al. [32]† | IMRT | Yes (86%) | 18 mths (8.4–76 mths) | 92% | 60% | 33% | 26.5 Gy | |
*Postoperative RT; †definitive and postoperative RT; all the rest: definitive RT.