Table 2 Parotid volumetric and dosimetric changes in HNSCC or NPC during curative RT or CRT

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

–

15%

10 to 37%

13 to 48%

–