ORIGINAL ARTICLE IMPROVEMENT IN XEROSTOMIA RELATED QUALITY OF LIFE OF ORAL CAVITY AND OROPHARYNGEAL SQUAMOUS CELL CARCINOMA PATIENTS TREATED WITH IMRT COMPARED TO CONVENTIONAL RT

Background: The incidence of head and neck squamous cell cancer is quite high in India as compared to the developed countries. Conventional RT for the majority of head and neck cancers is delivered using two parallel opposed radiation beams and parotid glands receive a significant radiation dose (>50 Gy) resulting in permanent xerostomia. Materials and Methods: For this study, we evaluated 64 patients with oral cavity and oropharyngeal squamous cell carcinomas, treated by IMRT / Conventional RT for xerostomia related quality of life (QoL). We used EORTC H&N35 QLQ for analysis of data & divided the questions into xerostomia experienced at rest and during meals. Results: Patients treated with IMRT reported significantly less difficulty in transporting and swallowing their food and needed less water for a dry mouth during day, night and meals. Within the IMRT group the xerostomia scores were better for those patients with mean parotid dose to the "spared " parotid < 26 Gy. Discussion: The parotids are responsible for the saliva output during meals whereas the oral cavity and submandibular glands lubricate the mouth at rest. Our results showed that patients receiving IMRT had a better xerostomia related QoL than patients who received bilateral opposed radiation fields. Xerostomia at rest and during meals was used as the endpoint in our analysis. Conclusion: Parotid gland sparing IMRT improves xerostomia related QoL