Interventions for the management of radiotherapy-induced xerostomia and hyposalivation: A systematic review and meta-analysis

Mercadante, Valeria; Hamad, Arwa Al; Lodi, Giovanni; Porter, Stephen; Fedele, Stefano

doi:10.1016/j.oraloncology.2016.12.031

Cited by 136 publications

(127 citation statements)

References 38 publications

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“…В результате распада и выведения СЖ клеточных структур РЖ увеличивается ее вязкость, повышается кислотность (pH≤5), что приводит к потере железой способности секретировать слюну; снижается (≤0,2 мл/мин) [19] или резко угнетается слюноотделение, развивается ксеростомия (0,1-0,2 мл/мин) [20,21]. При воздействии дозы ионизирующего излучения >10 Гр отмечают проявления ксеростомии разной степени тяжести у всех пациентов со ЗНО ЧЛО [5,6,13,18,21]. При суммарной дозе облучения (СОД) более 30 Гр проявления ксеростомии считают уже необратимыми [10,22].…”

Section: влияние ионизирующего излучения на структуру и функцию сж паunclassified

Radiation-associated changes in salivation of patients with cancer of maxillofacial region

Bykov¹,

Izhnina²,

Кочурова³

et al. 2018

Stomat.

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Section: влияние ионизирующего излучения на структуру и функцию сж паunclassified

Radiation-associated changes in salivation of patients with cancer of maxillofacial region

Bykov¹,

Izhnina²,

Кочурова³

et al. 2018

Stomat.

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“…Due to conflicting results their use is not recommended [11]. On the other hand, recent systematic review suggested that both pilocarpine and cevimeline can reduce xerostomia symptoms and increase salivary flow compared to placebo after RT but "some aspects of the relevant effect size, duration of the benefit, and clinical meaningfulness remain unclear" [65].…”

Section: Xerostomiamentioning

confidence: 99%

Oral Side Effects of Head and Neck Irradiation

Brailo¹,

Boras²,

Juras³

et al. 2017

Diagnosis and Management of Head and Neck Cancer

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Head and neck irradiation is the standard treatment of advanced oral/oropharyngeal cancer. The treatment has severe side effects such as mucositis, xerostomia, irradiation caries, trismus, and osteoradionecrosis. Side effects can lead to treatment discontinuation, infection, increased drug consumption, and increased duration of hospital admission and can have negative impact on the quality of life and overall survival. Furthermore, some of them (mucositis and xerostomia) affect almost every (>90%) patient. Since nearly two-thirds of oral/oropharyngeal cancers are diagnosed in advanced stage, one might conclude that the great majority of patients will be affected. However, these side effects can be prevented or at least reduced by proper oral/dental care. Therefore, every patient planned for head and neck irradiation should undergo dental evaluation before beginning of the treatment.

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“…At present, available treatment modalities for mouth dryness include the following: altering the intake of xerogenic medication when possible; shifting the radiation field to protect the salivary glands in head and neck cancer patients [i.e., intensity-modulated radiation therapy (IMRT)] (Wang & Eisbruch, 2016); local application of saliva substitutes and stimulants; systemic intake of muscarinic agonists (sialogogues), such as pilocarpine and cevimeline (Aframian, Helcer, Livni, & Markitziu, 2006;Mercadante, Al Hamad, Lodi, Porter, & Fedele, 2017); and electrostimulation devices (Wolff et al, 2018). Since the prevalence of salivary gland impairment is relatively common (Ship et al, 2002), more cost-effective modalities are needed to overcome this morbidity.…”

mentioning

confidence: 99%

Improvement of dry mouth following intraductal irrigation of salivary glands

et al. 2019

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Objectives To assess the effect of major salivary gland intraductal irrigations (IGs) to relieve mouth dryness. Methods We retrospectively analyzed the records of patients with mouth dryness who underwent major salivary gland IG during 2013–2015. Records included demographics, medical background, dry mouth etiologies and symptomatology, and results of sialometry and sialo‐cone‐beam computerized tomography. Subjective improvement following the IG procedure (yes/no) and sustained subjective improvement (mouth dryness relief for ≥1 month) were recorded. Objective improvement was assessed by comparing the mean unstimulated (USF) and stimulated (SSF) whole salivary flow (WSF) rate before and after the IG. Results Seventy‐four patients were included [mean age: 59.08 ± 12.46 years]. Improvement was detected in the USF (p = .027), but not in the SSF (p = .878). Fifty‐five (84.6%) noted subjective improvement, while 10 (15.4%) did not. Subjective improvement was positively associated with the USF following IG (p = .037), with salivary gland swelling episodes (p = .033), and with difficulties in swallowing dry foods (p = .014). Of those with subjective improvement, 45 (81.8%) reported sustained improvement, which was positively associated with lack of a gritty eye sensation (p = .042) and abnormal sialo‐CBCT findings (p = .001). Conclusions Major salivary gland IG is a simple and safe procedure that may relieve dry mouth for a relatively extended duration. Further studies are needed to confirm these preliminary findings and assess their underlying mechanisms.

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Interventions for the management of radiotherapy-induced xerostomia and hyposalivation: A systematic review and meta-analysis

Abstract: Introduction: Salivary gland hypofunction is a common and permanent adverse

Cited by 136 publications

References 38 publications

Radiation-associated changes in salivation of patients with cancer of maxillofacial region

Radiation-associated changes in salivation of patients with cancer of maxillofacial region

Oral Side Effects of Head and Neck Irradiation

Improvement of dry mouth following intraductal irrigation of salivary glands

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