Study | Sample Size (n) | Re-Scan Timing | Mean Parotid Volume Reduction (Range) by Fraction (Fx) 10 | Mean Parotid Volume Reduction (Range) by Fx 20 | Mean Parotid Volume Reduction (Range) by End of Treatment | Dosimetric: Mean Parotid Dose Change (Range) |
---|---|---|---|---|---|---|
Bhide IJROBP 2010 [8] | 20 (10 OPC, 6 Laryng or Hypoph, 4 NPC) | Weeks 2, 3, 4, 5 | 14.7% NS | – | 35% NS | Without ART: 2.8 Gy increase ipsi |
Capelle Clin Oncol 2012 [10] | 20 (17 HNSCC, 3 NPC) | Fx 15 | – | 17.5% NS (−1 to 46%) | – | With ART: 0.6 Gy reduction NS |
Lu Chin Med J 2012 [14] | 43 (43 NPC) | Fx 20 | – | 35.5 to 36.8% * | – | – |
Beltran J Appl Clin Med 2012 [18] | 16 (7 OPC, 5 OC, 1 Hypoph, 1 NPC, 2 NS) | Fx 15, 25 | – | 22% NS | 30% NS | Without ART: 4.7% increase Ipsi 6.1% increase Contra |
Schwartz Radiother Oncol 2013 [21] | 22 (22 OPC) | Daily scans, Weekly recalc | – | 15% NS (−19 to 25%) | 26% NS (−8 to 48%) | 1 ART re-plan: 1.3 Gy reduction ipsi 2 ART re-plans: 4.1 Gy reduction ipsi |
Chitapanarux J Radiat Res 2015 [11] | 17 (17 NPC) | Fx 17 | – | 30.5% ipsi 24.3% contra | – | With ART: 1.1 Gy reduction Contra Ipsilateral not significant (0.9 Gy) |
Huang Radiat Oncol 2015 [24] | 19 (19 NPC) | Every 5 Fx | – | 14.4 to 15.8% * | 38.0 to 39.2% * | Without ART: 3.09 Gy to 5.6 Gy increase * |
Dewan Asian Pac J 2016 [12] | 30 (15 OPC, 10 OC, 5 Hypoph) | Fx 20 | – | 33.65% ipsi 31.06% contra | – | With ART: 5.6 Gy reduction ipsi Contralateral not significant (2.7 Gy) |
Zhang J Med Radiat Sci 2017 [34] | 39 (39 NPC) | Fx 10, 20, 30 | – | 15.27% ipsi | 37.49% ipsi 34.55% contra | – |
Mahmoud Technol Cancer Res Treat 2017 [15] | 22 (11 OPC, 7 OC, 2 Laryng, 1 Hypoph, 1 NPC) | Fx 15, 27 | – | 18.2 to 19.0% * for definitive (3 to 32%) 10.0 to 16.6% * for adjuvant (5 to 44%) | 30.1 to 30.9% * for definitive (11 to 52%) 23.1 to 25.3% * for adjuvant (3 to 41%) | Without ART: 15.4 to 16.4% increase * for definitive (−30 to 76%) 9.1 to 10.4% increase * for postop (−25 to 70%) Neither significant given large heterogeneity |
Loo Clin Oncol 2011 [17] | 5 (3 OPC, 1 OC, 1 Laryng) | Weekly | – | – | 30.2% Ipsi (17.1 to 55.8%) 17.5% Contra (15.6 to 48.5%) | Without ART: 7.6 Gy increase Ipsi (2.5 to 19 Gy) 7.3 Gy increase Contra (1.1 to 11.6 Gy) |
Fung Med Dosim 2012 [19] | 10 (10 NPC) | Fx 21, 31 approx. | – | – | 32.44 to 33.31% * | With ART: 0.75 Gy reduction (right, p = 0.046) 1.25 Gy reduction (left, p = 0.053) |
Fung J Radiat Res 2014 [23] | 30 (30 NPC) | Every 2 Fx | – | – | 47.54% NS | – |
Hunter IJROBP 2013 [35] | 18 (18 OPC) | Weekly | – | – | 13.31% NS | Without ART: 0.92 Gy (median) increase NS (−4.9 to 8.4 Gy; not sig) 23/36 parotids had an increase (2.2 Gy median) |
Jin Radiat Oncol 2013 [5] | 9 (9 NPC) | Fx 23 | – | – | 38.4 to 40.68% * | – |
Castelli Radiat Oncol 2015 [3] | 15 (11 OPC, 2 OC, 1 Laryng, 1 Hypoph) | Weekly | – | – | 28.3% NS | Without ART: 67% of pts.: 4.8 Gy increase NS 33% of pts.: 3.9 Gy decrease NS With ART: Of those with overdosed parotids: 5.1Gy decrease NS (0.6 to 12.2 Gy) |
Yao Biomed Res Int 2015 [36] | 50 (50 NPC) | Every 5 Fx | – | – | 35% NS (6.8 to 69.4%) | Without ART: 3.52 Gy (11.38%) increase NS (−1.51 to 30.57%) Weight loss correlated with mean parotid dose |
Zhang Radiother Oncol 2016 [26] | 13 (13 OPC) | Weekly | – | – | 34.51% ipsi (10 to 57.6%) 27.98% contra (−5.2 to 57.3%) | Without ART: 16/23 parotids overdosed: 4.1 Gy increase NS (0.5 to 11.5 Gy) 3 ART re-plans: 3.1 Gy reduction NS 6 ART re-plans: 3.3 Gy reduction NS |
Hu BMC Cancer 2018 [40] | 40 (40 NPC) | Median Fx 22 | – | – | 17.2% Ipsi 20% Contra | With ART: 0.7 Gy reduction Ipsi Contralateral not significant (0.1 Gy) |
Lee IJROBP 2008 [4] | 10 (2 OPC, 5 NPC, 1 SN, 1 OPC + NPC, 1 UP) | Daily MV-CT | – | – | – | Without ART: 3 Gy (11%) NS (−6 to 42%) Parotid glands migrating closer to target volume had higher changes in mean dose |
Fiorentino Br J Radiol 2012 [41] | 10 (4 OPC, 5 OC, 1 Hypoph) | Daily | – | – | 43.5% Ipsi 44.0% Contra | – |
Range of median parotid volume reductions reported in the included studies | 15% | 10 to 37% | 13 to 48% | – |