Prospective audit of xerostomia following intensity modulated radiotherapy for head and neck cancer

Xerostomia can affect long term quality of life following radical radiotherapy for head and neck cancer. Sparing the parotid glands using IMRT significantly reduces the incidence of xerostoma.

The PARSPORT trial demonstrated that sparing the parotid glands using IMRT significantly reduces the incidence of xerostomia compared to conventional radiation treatment [1].

The standard: 

The IMRT Arm of PARSPORT (39 patients) [1].

Target: 

Mean contralateral parotid dose less than 24Gy. The proportion of patients who had grade 2 or worse xerostomia at 12 and 24 months = 38% and 29% respectively.

Indicators: 

The proportion of patients who had grade 2 or worse xerostomia at 12 and 24 months using the LENT SOMA scoring system. Mean contralateral parotid dose.

Data items to be collected: 

• The LENT SOMA scoring system questionnaire

• Mean contralateral parotid dose

Suggested number: 

39 patients.

Review the reasons why rates of grade 2 or worse xerostomia at 12 and 24 months are higher than in PARSPORT. This includes the mean contralateral parotid doses, patient population and proportion of patients having concurrent chemotherapy.

Prospective data collection required by completion of questionnaires by patients in follow up clinics or by telephone consultations between the patients and healthcare professionals.

1. Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial. Christopher M Nutting, James P Morden, Kevin J Harrington, Teresa Guerrero Urbano, Shreerang A Bhide, Catharine Clark, Elizabeth A Miles, Aisha B Miah, Kate Newbold, MaryAnne Tanay, Fawzi Adab, Sarah J Jeff eries, Christopher Scrase, Beng K Yap, Roger P A’Hern, Mark A Sydenham, Marie Emson, Emma Hall, on behalf of the PARSPORT trial management group. The Lancet. 2011.

Naomi Cole