The effect of parotid gland‐sparing intensity‐modulated radiotherapy on salivary composition, flow rate and xerostomia measures
Bibliographic record
Abstract
Objectives To describe parotid gland ( PG ) saliva organic and inorganic composition and flow rate changes, after curative intensity‐modulated radiotherapy ( IMRT ) for head and neck cancer ( HNC ), and analyse the relationship between PG saliva analytes and xerostomia measures. Methods and Materials Twenty‐six patients recruited to five prospective phase 2 or 3 trials which assessed toxicity and efficacy of IMRT by HNC subsite, provided longitudinal PG saliva. Salivary flow rate, and subjective and objective xerostomia measures were prospectively collected and saliva tested for inorganic and organic analytes. Statistical comparisons of longitudinal analyte changes and analysis for a relationship between dichotomized xerostomia score and saliva analytes were performed. Results One hundred and forty‐two PG saliva samples from 26 patients were analysed. At 3–6 months after IMRT , stimulated and unstimulated saliva showed significantly decreased flow rate, total protein ( TP ) secretion rate, phosphate concentration and increased lactoferrin ( LF ) concentration. Stimulated saliva alone had elevated LF secretion rate and beta‐2‐microglobulin (B 2 M) concentration with decreased calcium (Ca 2+ ) and magnesium (Mg 2+ ) concentrations and Ca 2+ secretion rate. At >12 months, under stimulated and unstimulated conditions, increased LF concentration and decreased Mg 2+ and phosphate concentration persisted and, in stimulated saliva, there was decreased potassium (K + ) and Mg 2+ concentration. Unstimulated TP secretion rate was lower in the presence of high‐grade xerostomia. Otherwise, no relationship between xerostomia grade and PG salivary flow rate, TP and Ca 2+ secretion rate was found. Conclusion Fewer significant differences in PG saliva analytes >12 months after IMRT indicate good functional recovery. Residual xerostomia after IMRT will only be further reduced by addressing the sparing of subsites of the PG or other salivary gland tissues, in addition to the PG .
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".