Explorative study on quality of life in relation to salivary secretion rate in head and neck cancer patients treated with radiotherapy up to 2 years post treatment

Almståhl, Annica; Andersson, Jessica Skoogh; Alstad, Torgny; Fagerberg-Mohlin, Bodil; Finizia, Caterina

doi:10.1111/idh.12363

Cited by 14 publications

(13 citation statements)

References 43 publications

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“…Their stimulated salivary secretion rate was determined at pretreatment and at 6 months, 1 year, and 2 years post treatment. Clinical status, minor gland secretion rates, stimulated whole salivary secretion rate and microflora on the tongue, buccal mucosa and supragingival plaque and quality of life has been reported previously [ 8 , 17 , 19 ]. In the present study, 29 patients were included.…”

Section: Methodsmentioning

confidence: 87%

“…Both MUC7 and MUC5B are glycoproteins and can interact with oral microbes to facilitate their removal and/or reduce their pathogenicity [ 15 ]. Previous studies have shown that patients often report problems with sticky saliva after treatment of cancer of the head and neck region [ 16 , 17 ]. Our previous study showed that the concentration of MUC5B in stimulated saliva decreases to about 75% of the concentration seen in healthy controls with normal salivary secretion rate [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Stimulated saliva composition in patients with cancer of the head and neck region

et al. 2021

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Background To analyse over time changes in stimulated whole saliva regarding total protein, Immunoglobulin A (IgA), and mucin type O-glycans (mostly MUC5B and MUC7) in head and neck cancer patients. Methods 29 dentate patients (20 men and 9 women, 59 ± 8 years) treated with curative radiation therapy and chemotherapy for cancer of the head and neck region were included. The stimulated whole salivary secretion rate was determined and saliva collected at four time-points: at pretreatment, and at 6 months, 1 and 2 years post treatment. The total protein concentration was determined spectrophotometrically by using Bicinchoninic Acid assay and Immunoglobulin A (IgA) by using ELISA technique. Glycosylation pattern of salivary mucins was determined in samples collected pre- and post treatment by using LC/MS electrospray and mucin content quantified using SDS-AgPAGE gels and PAS staining. Results Compared with pretreatment, the total protein concentration was increased already at 6 months post treatment (p < 0.01), and continued to increase up to 2 years post treatment (p < 0.001). During that period no significant changes in IgA concentration was detected. At pretreatment, the output/min of both total protein and IgA was significantly higher than at all time-points post treatment. Saliva from the cancer patients showed a low abundance/no detectable MUC7, while the MUC5B level remained, compared to saliva from a healthy control. The glycomic analysis showed that the percentage of core 2 O-glycans was increased as core 1, 3 and 4 O-glycans were decreased. The level of sialylation was higher at 6 months post treatment, while sulfation was lower. Conclusion A decreased output per minute of proteins at decreased salivary secretion rate, as well as reduced sulfation of MUC5B at 6 months post treatment tended to correlate with the patients’ experience of sticky saliva and oral dryness. At 2 years post treatment, the decreased amount of IgA combined with a lowered salivary secretion rate indicate a reduced oral defense with increased risk of oral infections.

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Section: Methodsmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Stimulated saliva composition in patients with cancer of the head and neck region

et al. 2021

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“…Treatment for cancer of the head and neck region may lead to late and/or chronic complications such as persistent xerostomia, low salivary secretion rate, sticky saliva, dysphagia, and trismus. (Almståhl et al, ; Deboni et al, ; Pauli et al, ) Due to decreased bone healing of irradiated bone, there is a risk of osteoradionecrosis, especially in patients who use tobacco or are alcohol abusers. (Epstein et al, ) In patients with low salivary secretion rate, there is an increased risk of caries.…”

Section: Discussionmentioning

confidence: 99%

“…Late side effects of cancer treatment are often irreversible and may occur several months to years after completed radiotherapy, for example, trismus, dysphagia, osteoradionecrosis, low salivary secretion rate, permanent xerostomia, and caries. (Almståhl, Finizia, Carlén, Fagerberg‐Mohlin, & Alstad, ; Almståhl, Skoogh Andersson, Alstad, Fagerberg‐Mohlin, & Finizia, ; Epstein et al, ; Moon et al, ; Pauli, Johnson, Finizia, & Andréll, )…”

Section: Introductionmentioning

confidence: 99%

Variations in odontological care routines for patients undergoing treatment for head and neck cancer in county councils/regions of Sweden

Bohm

Karlsson

Andersson

et al. 2019

Clinical & Exp Dental Res

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Objective To investigate current odontological care routines for patients treated for head and neck cancers in the county councils/regions (C/Rs) of Sweden. Methods An invitation to fill in a web‐based questionnaire was sent to dentists/dental hygienists working in dental clinics in the 12 C/Rs, treating and responsible for the odontological care of patients undergoing treatment for cancer of the head and neck. The questionnaire started with two mandatory and one non‐mandatory questions, followed by questions regarding routines before (n = 28), during (n = 23), and after (n = 9) treatment, plus two additional questions, totalling 65 questions. Results Four dental hygienists and six dentists in 10 of the 12 C/Rs answered the questionnaire. Three C/Rs stated that they measure both the unstimulated and stimulated salivary secretion rate, and another C/R stated that they measure the stimulated secretion rate only. Similar recommendations were given regarding oral hygiene, salivary stimulants and substitutes, and extra fluoride. However, great variations were seen regarding recommendations for preventing and relieving oral mucositis. There were also discrepancies regarding information about the importance of avoiding smoking and alcohol. In seven C/Rs, patients visited the dental hygienist once a week during cancer treatment. Conclusion The results suggests that there are great variations in odontological care given to patients undergoing treatment for cancer of the head and neck region in different county councils/regions in Sweden. There is a need to develop and implement evidence‐based guidelines to decrease the risk of oral complications and increase both the quality of life and the quality of care.

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“…Previous studies have shown that radiation treatment for head and neck cancer as well as Sjögren’s syndrome hampers healthy salivary gland function, thereby decreasing saliva quality and quantity (hyposalivation; Pedersen et al 2002). This condition can lead to oral infections, pain, and deficient nutritional status and decrease the quality of life for afflicted patients (Almstahl et al 2019). However, because current available treatments, such as secretory agonists and saliva substitutes, provide only temporary relief (Noaiseh et al 2014), there is an urgent need to develop alternative long-term solutions (Ozdemir et al 2016).…”

Section: Introductionmentioning

confidence: 99%

Trimers Conjugated to Fibrin Hydrogels Promote Salivary Gland Function

et al. 2020

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New strategies for tissue engineering have great potential for restoring and revitalizing impaired tissues and organs, including the use of smart hydrogels that can be modified to enhance organization and functionality of the salivary glands. For instance, monomers of laminin-111 peptides chemically conjugated to fibrin hydrogel (L1pM-FH) promote cell cluster formation in vitro and salivary gland regeneration in vivo when compared with fibrin hydrogel (FH) alone; however, L1pM-FH produce only weak expression of acinar differentiation markers in vivo (e.g., aquaporin-5 and transmembrane protein 16). Since previous studies demonstrated that a greater impact can be achieved when trimeric forms were used as compared with monomeric or dimeric forms, we investigated the extent to which trimers of laminin-111 chemically conjugated to FH (L1pT-FH) can increase the expression of acinar differentiation markers and elevate saliva secretion. In vitro studies using Par-C10 acinar cells demonstrated that when compared with L1pM-FH, L1pT-FH induced similar levels of acinar-like cell clustering, polarization, lumen formation, and calcium signaling. To assess the performance of the trimeric complex in vivo, we compared the ability of L1pM-FH and L1pT-FH to increase acinar differentiation markers and restore saliva flow rate in a salivary gland wound model of C57BL/6 mice. Our results show that L1pT-FH applied to wounded mice significantly improved the expression of the acinar differentiation markers and saliva secretion when compared with the monomeric form. Together, these positive effects of L1pT-FH warrant its future testing in additional models of hyposalivation with the ultimate goal of applying this technology in humans.

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Explorative study on quality of life in relation to salivary secretion rate in head and neck cancer patients treated with radiotherapy up to 2 years post treatment

Abstract: Patients with hyposalivation showed deterioration in health related quality of life (QoL) at 24 months compared with 12 months post RT. Most pronounced were problems with insomnia, swallowing, social eating, dry mouth, and sticky saliva.

Cited by 14 publications

References 43 publications

Stimulated saliva composition in patients with cancer of the head and neck region

Stimulated saliva composition in patients with cancer of the head and neck region

Variations in odontological care routines for patients undergoing treatment for head and neck cancer in county councils/regions of Sweden

Trimers Conjugated to Fibrin Hydrogels Promote Salivary Gland Function

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