Grading xerostomia by physicians or by patients after intensity-modulated radiotherapy of head-and-neck cancer

Meirovitz, Amichay; Murdoch‐Kinch, Carol Anne; Schipper, M.; Pan, Charlie C.; Eisbruch, Avraham

doi:10.1016/j.ijrobp.2006.05.002

Cited by 152 publications

(126 citation statements)

References 65 publications

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“…Fox et al, in a double-blind, placebo-controlled study of 39 patients with post-irradiation �erostomia, found 94.8% of the subjects to e�perience improvement after one month of treatment with 5 mg of pilocarpine three times a day -this improvement being maintained for 6 months after the end of radiotherapy (21). Many studies have shown that intensity-modulated radiotherapy contributes to improve salivary gland preservation (17,(22)(23)(24)(25). Dysgeusia induced by radiotherapy is conditioned by a series of factors: direct neuroto�ic action upon the taste receptor cells, �erostomia and possible overinfections.…”

Section: Discussionmentioning

confidence: 99%

Dental implications in oral cancer patients

et al. 2011

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Objectives. A study is made of the dental implications of oral cancer, with a view to avoiding the complications that appear once oncological treatment is started. Patients and Methods. The study comprised a total of 22 patients diagnosed with oral cancer according to clinical and histological criteria in the Service of Ma�illofacial Surgery (Dental Clinic of the University of Barcelona, Spain) during the period 1996-2005, and posteriorly treated in different hospital centers in Barcelona. Results. Of the 22 patients diagnosed with oral cancer in our Service, the present study finally analyzed the 12 subjects who reported for the dental controls. As regards the remaining 10 patients, 5 had died and 5 could not be located; these subjects were thus e�cluded from the analysis. All of the smokers had abandoned the habit. The most common tumor location was the lateral margin of the tongue. None of the patients visited the dentist regularly before the diagnosis of oral cancer. T1N0M0 was the most common tumor stage. Surgery was carried out in 50% of the cases, while 8.4% of the patients received radiotherapy and 41.6% underwent surgery with postoperative radiotherapy. In turn, 66.6% of the patients reported treatment sequelae such as dysgeusia, �erostomia or speech difficulties, and one patient suffered osteoradionecrosis. Forty-one percent of the patients did not undergo regular dental controls after cancer treatment. As regards oral and dental health, 16.6% presented caries, and 50% had active periodontal disease. Conclusions. Protocols are available for preventing the complications of oral cancer treatment, and thus for improving patient quality of life. However, important shortcomings in the application of such protocols on the part of the public health authorities make it difficult to reach these objectives.

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Section: Discussionmentioning

confidence: 99%

Dental implications in oral cancer patients

et al. 2011

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“…Patient-reported evaluation of xerostomia has been shown to be more reliable than practitioner-assessed scores. 84 Hyposalivation is objectively assessed by measuring stimulated and nonstimulated salivary flow and by individual major gland secretion. 85 Hyposalivation does not always correlate with the perception of dry mouth.…”

Section: Grading and Assessmentmentioning

confidence: 99%

Oral complications of cancer and cancer therapy

Epstein

Thariat

Bensadoun

et al. 2012

CA A Cancer J Clinicians

395

356

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Answer questions and earn CME/CNEOral complications resulting from cancer and cancer therapies cause acute and late toxicities that may be underreported, underrecognized, and undertreated. Recent advances in cancer treatment have led to changes in the incidence, nature, and severity of oral complications. As the number of survivors increases, it is becoming increasingly recognized that the aggressive management of oral toxicities is needed to ensure optimal long‐term oral health and general well‐being. Advances in care have had an impact on previously recognized oral complications and are leading to newly recognized adverse effects. Here, the authors briefly review advances in cancer therapy, including recent advances in surgery, oral care, radiation therapy, hematopoietic cell transplantation, and medical oncology; describe how these advances affect oral health; and discuss the frequent and/or severe oral health complications associated with cancer and cancer treatment and their effect upon long‐term health. Although some of the acute oral toxicities of cancer therapies may be reduced, they remain essentially unavoidable. The significant impact of long‐term complications requires increased awareness and recognition to promote prevention and appropriate intervention. It is therefore important for the primary oncologist to be aware of these complications so that appropriate measures can be implemented in a timely manner. Prevention and management is best provided via multidisciplinary health care teams, which must be integrated and communicate effectively in order to provide the best patient care in a coordinated manner at the appropriate time. CA Cancer J Clin 2012. © 2012 American Cancer Society.

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“…Longitudinal studies in H&N cancer patients support the hypothesis that the feeling of xerostomia increases and QoL decreases during and directly after treatment and is restored to pretreatment levels at least after 12 months, despite any remaining functional disability (4). Despite extensive research in this field, only a limited number of studies have simultaneously investigated the association between QoL, the general subjective feeling of xerostomia, and the amount of saliva during and after RT, whereas it remains uncertain whether and to what extent objective signs are in accordance with subjective symptoms (5,6). Modern RT techniques, such as intensity-modulated RT (IMRT), which are able to spare a large volume of the salivary glands, have been developed (2).…”

Section: Introductionmentioning

confidence: 99%

Assessment of xerostomia and its impact on quality of life in head and neck cancer patients undergoing radiation therapy

Memtsa

Tolia

Tzitzikas

et al. 2017

Molecular and Clinical Oncology

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Abstract. Xerostomia in head and neck (H&N) cancer patients significantly affects their quality of life (QoL). The aim of the present study was to investigate the associations among QoL, xerostomia and quantity of saliva in a sample of H&N cancer patients who had received conventional radiotherapy (RT). A total of 60 H&N adult patients were enrolled in this prospective study. The patients completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30), the Quality of Life Questionnaire Head and Neck Module (QLQ-H&N35) and the Greek version of the XQ questionnaire at 4 timepoints: At the beginning of RT, at the end of RT, 6 months after RT completion and 1 year after RT completion. Patients with distant metastases or serious comorbidities were excluded from the study. Salivary pH, and stimulated and unstimulated salivary flow rate were assessed. All functional scales and symptom scales, apart from cognitive functioning in QLQ-C30 and feeding tube in H&N35 exhibited an abrupt deterioration at timepoint 3 and were then gradually restored over time. The difference was statistically significant (P<0.001). XQ scores at different timepoints exhibited a statistically significant negative correlation with salivary flow rates. Salivary flow rate and XQ scores almost parallelled one another. Flow rates recovered at a mean level of 20% below baseline values at the end of the follow-up period. The subjective symptom of xerostomia parallelled salivary flow and QoL. Despite receiving conventional RT, the participants exhibited a considerable preservation of salivary gland function after 12 months, allowing some optimism regarding the course of xerostomia in selected patients.

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Grading xerostomia by physicians or by patients after intensity-modulated radiotherapy of head-and-neck cancer

Cited by 152 publications

References 65 publications

Dental implications in oral cancer patients

Dental implications in oral cancer patients

Oral complications of cancer and cancer therapy

Assessment of xerostomia and its impact on quality of life in head and neck cancer patients undergoing radiation therapy

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