Wang K, Tepper JE (2021) Radiation therapy-associated toxicity: Etiology, management, and prevention. CA Cancer J Clin 71:437–454. https://doi.org/10.3322/caac.21689

Article  PubMed  Google Scholar 

Barazzuol L, Coppes RP, van Luijk P (2020) Prevention and treatment of radiotherapy-induced side effects. Mol Oncol 14:1538–1554. https://doi.org/10.1002/1878-0261.12750

Article  PubMed  PubMed Central  Google Scholar 

Dahele M, Tol JP, Vergeer MR, Jansen F, Lissenberg-Witte BI, Leemans CR et al (2020) Is the introduction of more advanced radiotherapy techniques for locally-advanced head and neck cancer associated with improved quality of life and reduced symptom burden? Radiother Oncol 151:298–303. https://doi.org/10.1016/j.radonc.2020.08.026

Article  CAS  PubMed  Google Scholar 

Huang H, Miao J, Xiao X, Hu J, Zhang G, Peng Y et al (2022) Impact on xerostomia for nasopharyngeal carcinoma patients treated with superficial parotid lobe-sparing intensity-modulated radiation therapy (SPLS-IMRT): A prospective phase II randomized controlled study. Radiother Oncol 175:1–9. https://doi.org/10.1016/j.radonc.2022.07.006

Article  CAS  PubMed  Google Scholar 

Mercadante V, Jensen SB, Smith DK, Bohlke K, Bauman J, Brennan MT et al (2021) Salivary Gland Hypofunction and/or Xerostomia Induced by Nonsurgical Cancer Therapies:ISOO/MASCC/ASCO Guideline. J Clin Oncol 39:2825–2843. https://doi.org/10.1200/JCO.21.01208

Article  CAS  PubMed  Google Scholar 

Owosho AA, Thor M, Oh JH, Riaz N, Tsai CJ, Rosenberg H et al (2017) The role of parotid gland irradiation in the development of severe hyposalivation (xerostomia) after intensity-modulated radiation therapy for head and neck cancer: Temporal patterns, risk factors, and testing the QUANTEC guidelines. J Craniomaxillofac Surg 45:595–600. https://doi.org/10.1016/j.jcms.2017.01.020

Article  PubMed  PubMed Central  Google Scholar 

Nutting CM, Morden JP, Harrington KJ, Urbano TG, Bhide SA, Clark C, et al. (2011) Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial. Lancet Oncol 12:127–36. https://doi.org/10.1016/S1470-2045(10)70290‑4

Sommat K, Hussain A, Ong WS, Yit NLF, Khoo JBK, Soong YL et al (2019) Clinical and dosimetric predictors of physician and patient reported xerostomia following intensity modulated radiotherapy for nasopharyngeal cancer—A prospective cohort analysis. Radiother Oncol 138:149–157. https://doi.org/10.1016/j.radonc.2019.05.023

Article  PubMed  Google Scholar 

Little M, Schipper M, Feng FY, Vineberg K, Cornwall C, Murdoch-Kinch CA et al (2012) Reducing xerostomia after chemo-IMRT for head-and-neck cancer: beyond sparing the parotid glands. Int J Radiat Oncol Biol Phys 83:1007–1014. https://doi.org/10.1016/j.ijrobp.2011.09.004

Article  PubMed  Google Scholar 

Hawkins PG, Lee JY, Mao Y, Li P, Green M, Worden FP et al (2018) Sparing all salivary glands with IMRT for head and neck cancer: Longitudinal study of patient-reported xerostomia and head-and-neck quality of life. Radiother Oncol 126:68–74. https://doi.org/10.1016/j.radonc.2017.08.002

Article  PubMed  Google Scholar 

Varra V, Ross RB, Juloori A, Campbell S, Tom MC, Joshi NP et al (2019) Selectively sparing the submandibular gland when level Ib lymph nodes are included in the radiation target volume: An initial safety analysis of a novel planning objective. Oral Oncol 89:79–83. https://doi.org/10.1016/j.oraloncology.2018.12.021

Article  PubMed  Google Scholar 

Ou X, Miao Y, Wang X, Ding J, He X, Hu C (2017) The feasibility analysis of omission of elective irradiation to level IB lymph nodes in low-risk nasopharyngeal carcinoma based on the 2013 updated consensus guideline for neck nodal levels. Radiat Oncol 12:137. https://doi.org/10.1186/s13014-017-0869-x

Article  CAS  PubMed  PubMed Central  Google Scholar 

Van den Bosch L, van der Laan HP, van der Schaaf A, Oosting SF, Halmos GB, Witjes MJH et al (2021) Patient-Reported Toxicity and Quality-of-Life Profiles in Patients With Head and Neck Cancer Treated With Definitive Radiation Therapy or Chemoradiation. Int J Radiat Oncol Biol Phys 111:456–467. https://doi.org/10.1016/j.ijrobp.2021.05.114

Article  PubMed  Google Scholar 

Long SM, Singh A, Tin AL, O’Hara B, Cohen MA, Lee N et al (2022) Comparison of Objective Measures of Trismus and Salivation With Patient-Reported Outcomes Following Treatment for Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg 148:749–755. https://doi.org/10.1001/jamaoto.2022.1495

Article  PubMed  PubMed Central  Google Scholar 

Lin A, Helgeson ES, Treister NS, Schmidt BL, Patton LL, Elting LS et al (2022) The impact of head and neck radiotherapy on salivary flow and quality of life: Results of the ORARAD study. Oral Oncol 127:105783. https://doi.org/10.1016/j.oraloncology.2022.105783

Article  PubMed  PubMed Central  Google Scholar 

Steenbakkers R, van Rijn-Dekker MI, Stokman MA, Kierkels RGJ, van der Schaaf A, van den Hoek JGM et al (2022) Parotid Gland Stem Cell Sparing Radiation Therapy for Patients With Head and Neck Cancer: A Double-Blind Randomized Controlled Trial. Int J Radiat Oncol Biol Phys 112:306–316. https://doi.org/10.1016/j.ijrobp.2021.09.023

Article  PubMed  Google Scholar 

Loimu V, Seppala T, Kapanen M, Tuomikoski L, Nurmi H, Makitie A et al (2017) Diffusion-weighted magnetic resonance imaging for evaluation of salivary gland function in head and neck cancer patients treated with intensity-modulated radiotherapy. Radiother Oncol 122:178–184. https://doi.org/10.1016/j.radonc.2016.07.008

Article  PubMed  Google Scholar 

Fan WJ, Teng F, Luo YR, Yu W, Zhang Q, Lu YP et al (2020) Diffusion-weighted imaging as a follow-up modality for evaluation of major salivary gland function in nasopharyngeal carcinoma patients: a preliminary study. Strahlenther Onkol 196:530–541. https://doi.org/10.1007/s00066-020-01580-5

Article  PubMed  PubMed Central  Google Scholar 

Shi D, Qian JJ, Fan GH, Shen JK, Tian Y, Xu L (2019) Salivary gland function in nasopharyngeal carcinoma before and late after intensity-modulated radiotherapy evaluated by dynamic diffusion-weighted MR imaging with gustatory stimulation. Bmc Oral Health 19:288. https://doi.org/10.1186/s12903-019-0951-x

Article  PubMed  PubMed Central  Google Scholar 

Arab A, Wojna-Pelczar A, Khairnar A, Szabo N, Ruda-Kucerova J (2018) Principles of diffusion kurtosis imaging and its role in early diagnosis of neurodegenerative disorders. Brain Res Bull 139:91–98. https://doi.org/10.1016/j.brainresbull.2018.01.015

Article  PubMed  Google Scholar 

Zhao DW, Fan WJ, Fang XM, Luo YR, Wei J, Chen NX et al (2022) Sparing submandibular gland to alleviating acute xerostomia in patients with nasopharyngeal carcinoma treated with helical tomotherapy: Evaluation by diffusion kurtosis imaging. Radiother Oncol 172:91–98. https://doi.org/10.1016/j.radonc.2022.05.011

Article  CAS  PubMed  Google Scholar 

Fan WJ, Teng F, Liu G, Zhao DW, Li JF, Luo YR et al (2021) Diffusion weighted imaging in submandibular gland sparing helical tomotherapy for nasopharyngeal carcinoma. Radiother Oncol 157:247–254. https://doi.org/10.1016/j.radonc.2021.02.004

Article  PubMed  Google Scholar 

Chibly AM, Aure MH, Patel VN, Hoffman MP (2022) Salivary Gland Function, Development and Regeneration. Physiol Rev. https://doi.org/10.1152/physrev.00015.2021

Article  PubMed  PubMed Central  Google Scholar 

Grundmann O, Mitchell GC, Limesand KH (2009) Sensitivity of salivary glands to radiation: from animal models to therapies. J Dent Res 88:894–903. https://doi.org/10.1177/0022034509343143

Article  CAS  PubMed  PubMed Central  Google Scholar 

Li Y, Li X, Pang R, Yang G, Tian M, Zhao T et al (2022) Diagnosis, Prevention, and Treatment of Radiotherapy-Induced Xerostomia: A Review. J Oncol 2022:7802334. https://doi.org/10.1155/2022/7802334

Article  CAS  PubMed  PubMed Central  Google Scholar 

van Luijk P, Pringle S, Deasy JO, Moiseenko VV, Faber H, Hovan A, et al. (2015) Sparing the region of the salivary gland containing stem cells preserves saliva production after radiotherapy for head and neck cancer. Sci Transl Med 7:305ra147. https://doi.org/10.1126/scitranslmed.aac4441

Zhang Q, Wei YM, Qi YG, Li BS (2018) Early Changes in Apparent Diffusion Coefficient for Salivary Glands during Radiotherapy for Nasopharyngeal Carcinoma Associated with Xerostomia. Korean J Radiol 19:328–333. https://doi.org/10.3348/kjr.2018.19.2.328

Article  PubMed  PubMed Central  Google Scholar