Management of radiotherapy-induced salivary hypofunction and consequent xerostomia in patients with oral or head and neck cancer: meta-analysis and literature review

Lovelace, Tiffany L.; Fox, Nyssa F.; Ak, Sood; Nguyen, Shaun A.; Day, Terry A.

doi:10.1016/j.oooo.2014.01.229

Cited by 63 publications

(59 citation statements)

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“…We have previously commented [13] on the questionable validity of the systematic review and meta-analysis of Lovelace et al [14] and the systematic review performed by Jensen et al [12] also seem to have similar weaknesses such as the inclusion of non-randomised studies and linguistic constraints [36,37]. Other reviews focussed on single intervention [8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

“…Some of the available systematic reviews have not specifically focused on HNC patients but rather considered individuals with xerostomia due to a variety of causes [5]. Others focussed on single intervention [8][9][10][11], or presented a number of methodological weaknesses [12][13][14]. We have undertaken this multiple-treatment systematic review and meta-analysis in order to help estimate the effectiveness of available treatments and contribute to develop evidence-based guidelines for the management of radiotherapy-induced hyposalivation and xerostomia.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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“…This variability remains constant over the course of RT and is likely to reflect differences in patients' perception of the symptom. Significant variation in reporting of xerostomia has been previously documented in this setting [21,35] and also in the palliative care setting where dry mouth is also a common symptom [36].…”

Section: Discussionmentioning

confidence: 86%

“…[16] Salivary gland transfer is a further option but is also experimental, requires a surgical procedure and may not be suitable for all patients. [42] There remains a need, therefore, for further studies examining topical interventions for RIX and in particular to assess patient reported symptom scores and quality of life measures when assessing efficacy [35].…”

Section: Discussionmentioning

confidence: 99%

Radiotherapy-induced xerostomia, pre-clinical promise of LMS-611

Paterson

Caldwell

Porteous

et al. 2015

Support Care Cancer

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2ABSTRACT PURPOSE Radiotherapy induced xerostomia (RIX) is the most common permanent side effect of radiotherapy (RT) to the head and neck (H&N). There is no effective topical treatment. LMS-611 is a mimetic of a natural lamellar body which prevents thick secretions like saliva from congesting organs. Primary objective -assess saliva properties before and during RT to the H&N. Secondary objectives -re-assess saliva properties with the addition of LMS-611, measure inter-patient variability, correlate patient reported symptoms with laboratory measurements and design subsequent first-in-human clinical trial of LMS-611. METHODS Patients with H&N cancer receiving RT as primary treatment were recruited. Patients completed the Groningen RIX (GRIX) questionnaire and provided saliva samples at baseline, weeks 2, 4 and 6 of RT. Saliva adhesiveness and viscosity was tested by measuring time taken to travel 5cm down an inclined plane. RESULTS 30 patients were enrolled. The inclined plane test (IPT) results (seconds) were as follows: baseline 31.3, week-2: 49.7, week-4: 51.1, week-6: 55.7. Wide inter-patient variability was seen at baseline. GRIX scores increased as RT progressed. Spearman rank correlation coefficient of inclined plane tests with GRIX scores was -0.06 at baseline, week-2 0.25, week-4 0.12 and week-6 0.08. LMS-611 concentrations of 10mg/ml and 20mg/ml significantly reduced IPT times on saliva samples. CONCLUSIONS Saliva becomes more visco-adhesive and RIX worsens as RT progresses. There is little correlation between objective and subjective measures of RIX. The addition of LMS611to thick, sticky saliva restores its fluidity ex-vivo. This warrants in-vivo analysis of the effect of LMS-611 upon RIX.

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“…Furthermore, it has been reported that saliva volume does not always correlate with subjective symptoms of xerostomia . This study still included objective saliva volume as an outcome as purely subjective measurements may not be accepted by some for inclusion in meta‐analysis studies …”

Section: Discussionmentioning

confidence: 99%