Estimation of Long-Term Salivary Gland Damage Induced by Radiotherapy

Makkonen, Tanja; Nordman, E.

doi:10.3109/02841868709089980

Cited by 60 publications

(17 citation statements)

References 21 publications

(7 reference statements)

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“…All investigations and diagnostic procedures were carried out by the same physician. Inclusion criteria for this diagnostic, non-interventional study were: history of oral carcinoma, surgical and radiation therapy, time interval from start of radiation therapy >180 days (exclusion of early radiation side effects [8]), radiotherapy volume including the lower jaw, the total submandibular region and the salivary glands, and the cranial border of the radiation field being above the chin-mastoid plane [23]. All patients routinely underwent surgical and conservative teeth rehabilitation in the planning phase of radiotherapy.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of saliva flow rates, Candida colonization and susceptibility of Candida strains after head and neck radiation

2011

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Hyposalivation is a long-term effect in patients receiving head and neck radiation. Radiotherapy can predispose oral colonization by Candida species of the mucosa. This study aims to evaluate the correlation between hyposalivation, measured by unstimulated saliva flow rates (SFR) and fungal colonization of the oral cavity, and also the resistance of isolated Candida strains to antimicrobial therapy. Fifty-three consecutive patients with radiotherapy were examined for late radiation damage on dental hard tissue and the salivary glands (SFR over a period of 5 min). The SFR were divided into three different values of hyposalivation: grade I (SFR 0.1-0.25 ml/min), grade II (SFR ≤0.1 ml/min), and grade III (SFR = 0.0 ml/min). Candidal colonization was defined using Sabouraud agar and identified using API 20C AUX (biomerieux) in the patients' rinsing water. Susceptibility was tested with Etest (amphotericin B, ketoconacole, voriconacole, and fluconacole). Hyposalivation grade I was detected in 23% (9.1 × 10(1) colony forming units (cfu); range, 200-5,900 cfu), hyposalivation grade II in 26% (4.3 × 10(1) cfu; range, 110-3,300 cfu), and hyposalivation grade III in 51% (2.0 × 10(3) cfu; range, 300-19,475 cfu) of patients. A significant correlation between the SFR and candidal colonization and clinical presentation (European Organization for Research and Treatment of Cancer (EORTC) score) was detected (Mann-Whitney test, p = 0.031). Twenty Candida albicans and 27 non-albicans species were identified. The resistance of C. albicans was higher than that of non-albicans strains against antimicrobial agents. By comparison, amphotericin B showed the greatest and fluconazole the least effect. A higher value of hyposalivation correlates with a higher risk of candidal colonization in patients who have received radiotherapy and also with a higher EORTC score. The spectrum of Candida is wide and susceptibility against antifungal therapy differs. In long-term examinations of patients with xerostomia after radiotherapy, the EORTC score can be used to measure hyposalivation. Reduced susceptibility of C. albicans might introduce complications to therapy. Findings of more non-albicans strains show a change in colonization which should be examined in further studies.

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Section: Methodsmentioning

confidence: 99%

Evaluation of saliva flow rates, Candida colonization and susceptibility of Candida strains after head and neck radiation

2011

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“…Patients were screened in the radiotherapy clinic and were included if the radiotherapy volume included the lower jaw, the total submandibular region and at least the lower half of the parotid gland [15]. Teeth with a questionable prognosis with respect to the planned radiation therapy were extracted.…”

Section: Methodsmentioning

confidence: 99%

Long-term oral Candida colonization, mucositis and salivary function after head and neck radiotherapy

Grötz

Genitsariotis

Vehling³

et al. 2003

Supportive Care in Cancer

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The aim of this study was to follow the long-term effects of radiation therapy of head and neck malignancies on oral yeast colonization, mucositis and salivary function. Included in this prospective study were 32 patients with intended radiation therapy of a malignancy of the head and neck. In all patients the salivary glands lay within the radiation field and the patients had at least five teeth. The first examination was performed after oral hygiene instruction and removal of questionable teeth before the start of radiotherapy. The following examinations were conducted after 3, 6, 9 and 12 months. Together with the quantitative determination of Candida colonization, three "mucositis" variables were assessed: (1) examiner-rated mucositis score (LENT/SOMA), (2) patient-rated mucositis symptoms, and (3) scintigraphic salivary excretion fraction. The maximum Candida colonization was found 6 months after radiation therapy and this declined to above normal values after 12 months. Salivary flow was at a minimum 6 months after radiation therapy and had slightly recovered by 12 months. Examiner-rated mucositis and patient-rated xerostomia showed no significant recovery after 6 or 12 months. The results of this study show slight recovery of the oral ecological system. Although the causal role of a single parameter is not clear, persistently elevated Candida colonization should be taken into account therapeutically.

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“…Inclusion criteria for this diagnostic, noninterventional study were: history of oral carcinoma, surgical and radiation therapy, time interval from start of radiation therapy > 90 days (exclusion of early radiation side effects [9]), cranial border of the radiation field above the chin-mastoid plane [36]. As a standard clinical protocol at the University of Mainz before start of radiotherapy all patients routinely underwent surgical and conservative teeth rehabilitation.…”

Section: Methodsmentioning

confidence: 99%

Quantifying Radioxerostomia: Salivary Flow Rate, Examiner’s Score, and Quality of Life Questionnaire

Al‐Nawas

Al-Nawas²,

Kunkel³

et al. 2006

Strahlenther Onkol

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Estimation of Long-Term Salivary Gland Damage Induced by Radiotherapy

Cited by 60 publications

References 21 publications

Evaluation of saliva flow rates, Candida colonization and susceptibility of Candida strains after head and neck radiation

Evaluation of saliva flow rates, Candida colonization and susceptibility of Candida strains after head and neck radiation

Long-term oral Candida colonization, mucositis and salivary function after head and neck radiotherapy

Quantifying Radioxerostomia: Salivary Flow Rate, Examiner’s Score, and Quality of Life Questionnaire

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