Several studies and even randomized trials have shown that improved IMRT optimization can reduce salivary and swallowing toxicity from head and neck radiation. This study took a look at oral cavity and salivary OAR dosimetry among 86 patients treated on two elective nodal irradiation trials. Dry mouth at 3 months was significantly associated with oral cavity V40 <25.9%, oral cavity mean dose <29.3 Gy, contralateral parotid V15 <35.1%, and contralateral submandibular gland V30 <61.5%. The latter two were also associated with dry mouth at 12 months. Better swallowing at 12 months was significantly associated with oral cavity V20 <57.1%, oral cavity V40 <25.9%, oral cavity mean dose <29.3 Gy, ipsilateral tubarial gland mean dose <41.3 Gy, and contralateral tubarial gland mean dose <25.5 Gy. All of this is to say that the more you can delineate oral substructures and constrain their dose, the less salivary and swallowing toxicity patients will experience after treatment. | Koneru, Int J Radiat Oncol Biol Phys 2025
