{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T10:36:23Z","timestamp":1788777383314,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T00:00:00Z","timestamp":1726531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>The aim of this study was to identify dose constraints for the parotid ducts that limit patient\u2010reported xerostomia and estimate whether these constraints are achieved during conventional parotid gland sparing radiation therapy (PGS\u2010RT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and materials<\/jats:title><jats:p>Thirty\u2010eight oropharyngeal squamous cell carcinoma patients were treated prospectively on trial with MRI sialography\u2010guided parotid duct sparing radiation therapy (PDS\u2010RT). PDS\u2010RT explicitly minimizes dose to the parotid ducts in addition to PGS\u2010RT. Parotid duct dose constraints were identified that distinguished patients reporting high and low rates of xerostomia. Atlas\u2010based parotid duct contours were generated on a retrospective cohort of similar patients where the parotid ducts were not contoured nor explicitly spared to estimate the dose received by the parotid ducts during PGS\u2010RT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients whose intraglandular parotid ducts or total parotid ducts were planned for a mean dose\u00a0&lt;\u00a014\u00a0Gy and\u00a0&lt;\u00a012\u00a0Gy, respectively, reported significantly (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01) lower rates of xerostomia at 6 and 12 months post\u2010RT. Patients receiving PDS\u2010RT had average total and intraglandular duct doses of 11.6\u00a0 and 13.6\u00a0Gy, respectively, compared to an estimated 23.8\u00a0 and 22.1\u00a0Gy, for those receiving PGS\u2010RT (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01). Only 6% (6\/108) and 20% (22\/108) of patients receiving PGS\u2010RT were estimated to meet the dose constraints for the total ducts and intraglandular ducts, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Parotid duct dose thresholds exist that appear to distinguish patients with and without xerostomia. The identified dose thresholds are frequently not met in PGS\u2010RT plans. In addition to reducing the dose to the parotid gland(s), parotid duct sparing may also further reduce xerostomia.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.14515","type":"journal-article","created":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T14:38:16Z","timestamp":1726583896000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Identifying dose constraints for the parotid ducts to minimize patient\u2010reported xerostomia: Is conventional mean dose sparing of the parotid glands sufficient?"],"prefix":"10.1002","volume":"25","author":[{"given":"Manal","family":"Ahmidouch","sequence":"first","affiliation":[{"name":"University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiva K.","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Washington University at St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colette","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence B.","family":"Marks","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhishamjit S.","family":"Chera","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Medical University of South Carolina  Charleston South Carolina 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