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Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage.

Pinna R, Campus G, Cumbo E, Mura I, Milia E - Ther Clin Risk Manag (2015)

Bottom Line: In addition, a modified diet and the patient's motivation to enhance oral hygiene can lead to a significant improvement.It could depend on the type of cancer treatment and the cumulative radiation dose to the gland tissue.A preventive approach and the correct treatment of the particular radiotherapeutic patient can help to improve the condition of xerostomia.

View Article: PubMed Central - PubMed

Affiliation: Department of Biomedical Science, University of Sassari, Sassari, Italy.

ABSTRACT

Background: The irradiation of head and neck cancer (HNC) often causes damage to the salivary glands. The resulting salivary gland hypofunction and xerostomia seriously reduce the patient's quality of life.

Purpose: To analyze the literature of actual management strategies for radiation-induced hypofunction and xerostomia in HNC patients.

Methods: MEDLINE/PubMed and the Cochrane Library databases were electronically evaluated for articles published from January 1, 1970, to June 30, 2013. Two reviewers independently screened and included papers according to the predefined selection criteria.

Results: Sixty-one articles met the inclusion criteria. The systematic review of the literature suggests that the most suitable methods for managing the clinical and pathophysiological consequences of HNC radiotherapy might be the pharmacological approach, for example, through the use of cholinergic agonists when residual secretory capacity is still present, and the use of salivary substitutes. In addition, a modified diet and the patient's motivation to enhance oral hygiene can lead to a significant improvement.

Conclusion: Radiation-induced xerostomia could be considered a multifactorial disease. It could depend on the type of cancer treatment and the cumulative radiation dose to the gland tissue. A preventive approach and the correct treatment of the particular radiotherapeutic patient can help to improve the condition of xerostomia.

No MeSH data available.


Related in: MedlinePlus

Viscous appearance of the saliva in a radiotherapeutic patient.
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f2-tcrm-11-171: Viscous appearance of the saliva in a radiotherapeutic patient.

Mentions: Xerostomia may affect 80% of the patients who need radiotherapy as a primary treatment, as an adjunct to surgery, in combination with chemotherapy, or as palliation.42–44 Hyposalivation represents the biggest acute side effect in HNC radiotherapy and, in general, is always associated with oral function problems, such as chewing and swallowing, or caries at a later stage. Normally, during radiotherapy, salivary composition may change and it becomes more viscous than usual, so its color may turn yellow, brown, or even white (Figure 2). Furthermore, salivary glands with high flow rates before the initiation of radiotherapy show less reduction in salivary flow rate. As a consequence of the reduction in the rate of saliva flow, which is correlated to the amount of radiation given to the patient, oral complications occur.20


Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage.

Pinna R, Campus G, Cumbo E, Mura I, Milia E - Ther Clin Risk Manag (2015)

Viscous appearance of the saliva in a radiotherapeutic patient.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325830&req=5

f2-tcrm-11-171: Viscous appearance of the saliva in a radiotherapeutic patient.
Mentions: Xerostomia may affect 80% of the patients who need radiotherapy as a primary treatment, as an adjunct to surgery, in combination with chemotherapy, or as palliation.42–44 Hyposalivation represents the biggest acute side effect in HNC radiotherapy and, in general, is always associated with oral function problems, such as chewing and swallowing, or caries at a later stage. Normally, during radiotherapy, salivary composition may change and it becomes more viscous than usual, so its color may turn yellow, brown, or even white (Figure 2). Furthermore, salivary glands with high flow rates before the initiation of radiotherapy show less reduction in salivary flow rate. As a consequence of the reduction in the rate of saliva flow, which is correlated to the amount of radiation given to the patient, oral complications occur.20

Bottom Line: In addition, a modified diet and the patient's motivation to enhance oral hygiene can lead to a significant improvement.It could depend on the type of cancer treatment and the cumulative radiation dose to the gland tissue.A preventive approach and the correct treatment of the particular radiotherapeutic patient can help to improve the condition of xerostomia.

View Article: PubMed Central - PubMed

Affiliation: Department of Biomedical Science, University of Sassari, Sassari, Italy.

ABSTRACT

Background: The irradiation of head and neck cancer (HNC) often causes damage to the salivary glands. The resulting salivary gland hypofunction and xerostomia seriously reduce the patient's quality of life.

Purpose: To analyze the literature of actual management strategies for radiation-induced hypofunction and xerostomia in HNC patients.

Methods: MEDLINE/PubMed and the Cochrane Library databases were electronically evaluated for articles published from January 1, 1970, to June 30, 2013. Two reviewers independently screened and included papers according to the predefined selection criteria.

Results: Sixty-one articles met the inclusion criteria. The systematic review of the literature suggests that the most suitable methods for managing the clinical and pathophysiological consequences of HNC radiotherapy might be the pharmacological approach, for example, through the use of cholinergic agonists when residual secretory capacity is still present, and the use of salivary substitutes. In addition, a modified diet and the patient's motivation to enhance oral hygiene can lead to a significant improvement.

Conclusion: Radiation-induced xerostomia could be considered a multifactorial disease. It could depend on the type of cancer treatment and the cumulative radiation dose to the gland tissue. A preventive approach and the correct treatment of the particular radiotherapeutic patient can help to improve the condition of xerostomia.

No MeSH data available.


Related in: MedlinePlus