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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

Cheilitis and cracked lips, and teeth cervical caries in a radiotherapeutic patient.
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f4-tcrm-11-171: Cheilitis and cracked lips, and teeth cervical caries in a radiotherapeutic patient.

Mentions: The buccal mucosa has a dry and sticky appearance (Figure 3). The normally moist, glistening appearance of the oral cavity is often replaced with a thin, pale, cracked appearance that is more susceptible to gingivitis and bleeding. Another frequent acute side effect is oral mucositis, which can be experienced by >50% of patients receiving HNC radiotherapy. Some typical side effects are onset of erythema, edema, and pain in the oral mucosa.41 Patients may also exhibit a dry irritated tongue with an erythematous appearance of the dorsal surface, the hard or soft palate, the commissures of the mouth, and under-removable prostheses.43 Furthermore, the lack of saliva may lead to angular cheilitis, cracked lips (Figure 4), periodontal disease, aching of the mouth, and halitosis.


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)

Cheilitis and cracked lips, and teeth cervical caries in a radiotherapeutic patient.
© Copyright Policy
Related In: Results  -  Collection

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

f4-tcrm-11-171: Cheilitis and cracked lips, and teeth cervical caries in a radiotherapeutic patient.
Mentions: The buccal mucosa has a dry and sticky appearance (Figure 3). The normally moist, glistening appearance of the oral cavity is often replaced with a thin, pale, cracked appearance that is more susceptible to gingivitis and bleeding. Another frequent acute side effect is oral mucositis, which can be experienced by >50% of patients receiving HNC radiotherapy. Some typical side effects are onset of erythema, edema, and pain in the oral mucosa.41 Patients may also exhibit a dry irritated tongue with an erythematous appearance of the dorsal surface, the hard or soft palate, the commissures of the mouth, and under-removable prostheses.43 Furthermore, the lack of saliva may lead to angular cheilitis, cracked lips (Figure 4), periodontal disease, aching of the mouth, and halitosis.

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