{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T22:47:15Z","timestamp":1782168435275,"version":"3.54.5"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T00:00:00Z","timestamp":1700697600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>This retrospective study aimed to evaluate the time to recovery from xerostomia and analyze its predictors, along with long-term outcomes of stimulated salivary flow after intensity-modulated radiation therapy (IMRT) for head and neck cancer (HNC). We evaluated patients with HNC who had received IMRT with curative intent between 2012 and 2018 at our institution. The salivary recovery ratio (SRR) was defined as \u2018(the stimulated salivary flow)\/(pre-treatment salivary flow)\u2019. The cutoff value of SRR in salivary recovery was estimated via the relationship between SRR and xerostomia grades. The salivary recovery time was defined as the time for SRR to exceed cutoff values from the end of radiotherapy. Fifty-seven patients were analyzed, with a 48-month median follow-up period of stimulated salivary flow. The cutoff value for SRR was 44.8%, and patients with a higher grade of xerostomia had a lower SRR (P\u2009&amp;lt;\u20090.001). The median salivary recovery time was 12\u00a0months. The cumulative incidence rates of salivary recovery at two and four years were 84 (95% confidence interval [CI]: 53\u201379) and 92% (95% CI: 82\u201397), respectively, and these were significantly lower in patients with a higher mean parotid gland dose, mean oral cavity dose and stimulated salivary flow per parotid gland volume. Stimulated salivary flow and xerostomia recover over a long period after radiotherapy.<\/jats:p>","DOI":"10.1093\/jrr\/rrad087","type":"journal-article","created":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T01:58:37Z","timestamp":1700791117000},"page":"71-77","source":"Crossref","is-referenced-by-count":10,"title":["Long-term outcomes of stimulated salivary flow and xerostomia after definitive intensity-modulated radiation therapy for patients with head and neck cancer"],"prefix":"10.1093","volume":"65","author":[{"given":"Shinya","family":"Hiraoka","sequence":"first","affiliation":[{"name":"Graduate School of Medicine, Kyoto University Department of Radiation Oncology and Image-Applied Therapy, , 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michio","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"Graduate School of Medicine, Kyoto University Department of Radiation Oncology and Image-Applied Therapy, , 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Graduate School of Medicine, Kyoto University Department of Radiation Oncology and Image-Applied Therapy, , 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryota","family":"Nakashima","sequence":"additional","affiliation":[{"name":"Graduate School of Medicine, Kyoto University Department of Radiation Oncology and Image-Applied Therapy, , 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Mizowaki","sequence":"additional","affiliation":[{"name":"Graduate School of Medicine, Kyoto University Department of Radiation Oncology and Image-Applied Therapy, , 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,11,22]]},"reference":[{"key":"2024012223562842100_ref1","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1097\/00002820-200511000-00004","article-title":"Eating problems and weight loss for patients with head and neck cancer: a chart review from diagnosis until one year after treatment","volume":"28","author":"Larsson","year":"2005","journal-title":"Cancer Nurs"},{"key":"2024012223562842100_ref2","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1056\/NEJMra1715715","article-title":"Head and neck cancer","volume":"382","author":"Chow","year":"2020","journal-title":"N Engl J Med"},{"key":"2024012223562842100_ref3","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.radonc.2017.08.002","article-title":"Sparing all salivary glands with IMRT for head and neck cancer: longitudinal study of patient-reported xerostomia and head-and-neck quality of life","volume":"126","author":"Hawkins","year":"2018","journal-title":"Radiother Oncol"},{"key":"2024012223562842100_ref4","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1002\/hed.10129","article-title":"Patients with head and neck cancer cured by radiation therapy: a survey of the dry mouth syndrome in long-term survivors","volume":"24","author":"Wijers","year":"2002","journal-title":"Head Neck"},{"key":"2024012223562842100_ref5","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/S1470-2045(10)70290-4","article-title":"Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial","volume":"12","author":"Nutting","year":"2011","journal-title":"Lancet Oncol"},{"key":"2024012223562842100_ref6","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1016\/S0360-3016(01)01512-7","article-title":"Xerostomia and its predictors following parotid-sparing irradiation of head-and-neck cancer","volume":"50","author":"Eisbruch","year":"2001","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024012223562842100_ref7","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.radonc.2015.07.041","article-title":"CT-based delineation of organs at risk in the head and neck region: DAHANCA, EORTC, GORTEC, HKNPCSG, NCIC CTG, NCRI, NRG oncology and TROG consensus guidelines","volume":"117","author":"Brouwer","year":"2015","journal-title":"Radiother Oncol"},{"key":"2024012223562842100_ref8","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1002\/art.1780281008","article-title":"A quantitative test for xerostomia. 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