Optimization of radiotherapy to reduce xerostomia is difficult, because many gland locations cannot be seen with current imaging modalities and biological dose-effect are currently insufficiently understood. PSMA PET is a new diagnostic instrument which can visualize the presence of vital acinar cells in salivary gland locations throughout the head and neck, with a sensitive and quantitative signal. A reduction of PSMA accumulation in salivary glands is thought to correlate with loss of vital acinar cells. The PET images can be correlated with radiotherapy dose distributions in gland-based or voxel-based evaluations. This makes PSMA PET a suitable instrument to derive the radiobiological dose-effect relations that are required to develop better and gland-specific dose constraints for radiotherapy. The results of this study can contribute to lower toxicity and better quality of life in patients treated with high-dose radiotherapy in the head and neck.
Primary objective of this prospective observational study is to determine the gland-based dose-effect relation between conventionally fractionated radiotherapy (RT) and long-term loss of acinar cells, per salivary gland type. The study population consists of a maximum of 20 patients with HNSCC referred for high-dose (CC)RT. There is no therapeutic intervention. Diagnostic intervention is PSMA PET/CT.
Study Type
OBSERVATIONAL
Enrollment
32
PSMA PET is a new diagnostic instrument which can visualize the presence of vital acinar cells in salivary gland locations throughout the head and neck, with a sensitive and quantitative signal.
The Netherlands Cancer Institute- Antoni van Leeuwenhoek (NKI-AVL)
Amsterdam, North Holland, Netherlands
University Medical Center Groningen
Groningen, Netherlands
University Medical Center Utrecht
Utrecht, Netherlands
the mean received radiation dose to salivary glands (Dmean), and the total uptake of PSMA in salivary glands (SUVtotal) and its relative reduction after radiotherapy (ΔSUVtotal-6).
Dmean and ΔSUVtotal-6 are correlated to determine the dose-effect relation.
Time frame: 6 months
ΔSUV
Time frame: 1 month
the clinical evaluation of a dry mouth
according to the C30+HN35 QoL
Time frame: before treatment, once during 7 weeks of treatment and follow up 6 months after
the clinical evaluation of a dry mouth
Groningen questionnaires
Time frame: before treatment, once a week during 7 weeks of treatment and follow up 6 months after
voxel-based ΔSUV
Time frame: 7 weeks of treatment, follow-up 1 and 6 months
Voxel-based received radiation dose
Time frame: 7 weeks of treatment, 1 and 6 months
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