Early prediction of parotid glands secretory function based on ADC variations during radiotherapy for nasopharyngeal carcinoma: a phase II prospective study
Abstract Objectives This study aimed to quantify dynamic changes in the Apparent Diffusion Coefficient (ADC) values of the parotid glands during radiotherapy and explore their correlation with early-stage gland dysfunction. Methods Nasopharyngeal carcinoma patients receiving definitive chemoradiothe...
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BMC
2025-07-01
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| Series: | Radiation Oncology |
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| Online Access: | https://doi.org/10.1186/s13014-025-02696-7 |
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| author | He Wang Ming Fan Lu Yan Xiaoli Du Lu Li Xin Lai Jun Yin Lucia Clara orlandini Jing Ren Qingping Yin Jiao Pei Yazhou Ren Jinyi Lang Qichao Zhou Mei Feng |
| author_facet | He Wang Ming Fan Lu Yan Xiaoli Du Lu Li Xin Lai Jun Yin Lucia Clara orlandini Jing Ren Qingping Yin Jiao Pei Yazhou Ren Jinyi Lang Qichao Zhou Mei Feng |
| author_sort | He Wang |
| collection | DOAJ |
| description | Abstract Objectives This study aimed to quantify dynamic changes in the Apparent Diffusion Coefficient (ADC) values of the parotid glands during radiotherapy and explore their correlation with early-stage gland dysfunction. Methods Nasopharyngeal carcinoma patients receiving definitive chemoradiotherapy were prospectively enrolled. Magnetic Resonance Diffusion-Weighted Imaging (MR-DWI) was performed at pre-radiotherapy (pre-RT), the 5th, 15th fractions, and end of radiotherapy. ADC values and volumes for ipsilateral (IP) and contralateral parotid glands (CP) were recorded. Salivary function was assessed using scintigraphy (SGS) and the Radiation Therapy Oncology Group (RTOG) xerostomia criteria. Results A total of 80 eligible patients were analyzed. From pre-radiotherapy(pre-RT) to the end of radiotherapy, Pearson correlation analysis showed that changes in ADC values were positively correlated with the delivered dose (p < 0.01) and reduction in parotid volume (p < 0.01).From pre-RT to the 5th fraction, mean ADC values((ΔADC5) increased significantly by 17.7% (IP) and 16.3% (CP) (p < 0.01), with minimal volume changes(ΔrV5) (p = 0.060, p = 0.068). Spearman analysis revealed a positive association between the change in ΔADC5 and the incidence of xerostomia 6 months after radiotherapy (p < 0.01). Multivariable analysis identified ΔADC5 rather than ΔrV5 as an independent predictor of secretory dysfunction (IP: Odds Ratio (OR) = 1.010, p = 0.015 by SGS; OR = 1.026, p = 0.000 by RTOG; CP: OR = 1.017, p = 0.004 by SGS; OR = 1.015, p = 0.002 by RTOG). Conclusion This study analyze the dynamic changes in parotid gland ADC values, volume, and secretion function throughout radiotherapy. Changes in ΔADC5 can predict radiation-induced parotid gland injury before significant volume changes occur, thereby enabling early intervention. |
| format | Article |
| id | doaj-art-40c5298bb4ec48c6a977cfe1b7245e73 |
| institution | DOAJ |
| issn | 1748-717X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | Radiation Oncology |
| spelling | doaj-art-40c5298bb4ec48c6a977cfe1b7245e732025-08-20T03:05:07ZengBMCRadiation Oncology1748-717X2025-07-0120111010.1186/s13014-025-02696-7Early prediction of parotid glands secretory function based on ADC variations during radiotherapy for nasopharyngeal carcinoma: a phase II prospective studyHe Wang0Ming Fan1Lu Yan2Xiaoli Du3Lu Li4Xin Lai5Jun Yin6Lucia Clara orlandini7Jing Ren8Qingping Yin9Jiao Pei10Yazhou Ren11Jinyi Lang12Qichao Zhou13Mei Feng14Department of Oncology, Affiliated Hospital of Sichuan Nursing Vocational College, The Third People’s Hospital of Sichuan ProvinceDepartment of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaDepartment of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaDepartment of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaDepartment of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaDepartment of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaDepartment of Oncology, Affiliated Hospital of Sichuan Nursing Vocational College, The Third People’s Hospital of Sichuan ProvinceDepartment of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaDepartment of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaDepartment of Oncology, Affiliated Hospital of Sichuan Nursing Vocational College, The Third People’s Hospital of Sichuan ProvinceDepartment of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaSchool of Computer Science and Engineering, University of Electronic Science and Technology of ChinaDepartment of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaManteia Technologies Co., LtdDepartment of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaAbstract Objectives This study aimed to quantify dynamic changes in the Apparent Diffusion Coefficient (ADC) values of the parotid glands during radiotherapy and explore their correlation with early-stage gland dysfunction. Methods Nasopharyngeal carcinoma patients receiving definitive chemoradiotherapy were prospectively enrolled. Magnetic Resonance Diffusion-Weighted Imaging (MR-DWI) was performed at pre-radiotherapy (pre-RT), the 5th, 15th fractions, and end of radiotherapy. ADC values and volumes for ipsilateral (IP) and contralateral parotid glands (CP) were recorded. Salivary function was assessed using scintigraphy (SGS) and the Radiation Therapy Oncology Group (RTOG) xerostomia criteria. Results A total of 80 eligible patients were analyzed. From pre-radiotherapy(pre-RT) to the end of radiotherapy, Pearson correlation analysis showed that changes in ADC values were positively correlated with the delivered dose (p < 0.01) and reduction in parotid volume (p < 0.01).From pre-RT to the 5th fraction, mean ADC values((ΔADC5) increased significantly by 17.7% (IP) and 16.3% (CP) (p < 0.01), with minimal volume changes(ΔrV5) (p = 0.060, p = 0.068). Spearman analysis revealed a positive association between the change in ΔADC5 and the incidence of xerostomia 6 months after radiotherapy (p < 0.01). Multivariable analysis identified ΔADC5 rather than ΔrV5 as an independent predictor of secretory dysfunction (IP: Odds Ratio (OR) = 1.010, p = 0.015 by SGS; OR = 1.026, p = 0.000 by RTOG; CP: OR = 1.017, p = 0.004 by SGS; OR = 1.015, p = 0.002 by RTOG). Conclusion This study analyze the dynamic changes in parotid gland ADC values, volume, and secretion function throughout radiotherapy. Changes in ΔADC5 can predict radiation-induced parotid gland injury before significant volume changes occur, thereby enabling early intervention.https://doi.org/10.1186/s13014-025-02696-7Nasopharyngeal carcinomaRadiotherapyParotid glandXerostomiaDiffusion weighted imaging |
| spellingShingle | He Wang Ming Fan Lu Yan Xiaoli Du Lu Li Xin Lai Jun Yin Lucia Clara orlandini Jing Ren Qingping Yin Jiao Pei Yazhou Ren Jinyi Lang Qichao Zhou Mei Feng Early prediction of parotid glands secretory function based on ADC variations during radiotherapy for nasopharyngeal carcinoma: a phase II prospective study Radiation Oncology Nasopharyngeal carcinoma Radiotherapy Parotid gland Xerostomia Diffusion weighted imaging |
| title | Early prediction of parotid glands secretory function based on ADC variations during radiotherapy for nasopharyngeal carcinoma: a phase II prospective study |
| title_full | Early prediction of parotid glands secretory function based on ADC variations during radiotherapy for nasopharyngeal carcinoma: a phase II prospective study |
| title_fullStr | Early prediction of parotid glands secretory function based on ADC variations during radiotherapy for nasopharyngeal carcinoma: a phase II prospective study |
| title_full_unstemmed | Early prediction of parotid glands secretory function based on ADC variations during radiotherapy for nasopharyngeal carcinoma: a phase II prospective study |
| title_short | Early prediction of parotid glands secretory function based on ADC variations during radiotherapy for nasopharyngeal carcinoma: a phase II prospective study |
| title_sort | early prediction of parotid glands secretory function based on adc variations during radiotherapy for nasopharyngeal carcinoma a phase ii prospective study |
| topic | Nasopharyngeal carcinoma Radiotherapy Parotid gland Xerostomia Diffusion weighted imaging |
| url | https://doi.org/10.1186/s13014-025-02696-7 |
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