Abstract:Saliva and serum electrolyte concentrations were monitored in 30 patients given a course of xerostomia-producing cancer radiotherapy. The mean flow r a t e of stimulated whole saliva decreased 83.3% during a 6-week treatment period. The striking reduction in saliva o u t p u t was accompanied by significant increases in saliva Na+, C1-, Cat+, Mg" and Prot.-concentrations and by a decrease i n saliva HCO; content. The xerostomic saliva was more concentrated and had a greater salinity t h a n t h e pretreatment … Show more
“…Xerostomia can result in long-term or even permanent oral function impairment and usually is associated with morbidity that profoundly affects the quality of life. [1][2][3][4] Several potential methods for preventing radiation-induced xerostomia have been described; however, xerostomia management is complex and often is refractory to most interventions. 5 Studies using systemic sialogogues (e.g., pilocarpine) concomitant with RT have failed to show significant maintenance of saliva production.…”
The aim of this study was to evaluate the effectiveness of acupuncture in minimizing the severity of radiation-induced xerostomia in patients with head and neck cancer. A total of 24 consecutive patients receiving > 5000 cGy radiotherapy (RT) involving the major salivary glands bilaterally were assigned to either the preventive acupuncture group (PA, n = 12), treated with acupuncture before and during RT, or the control group (CT, n = 12), treated with RT and not receiving acupuncture. After RT completion, clinical response was assessed in all patients by syalometry, measuring the resting (RSFR) and stimulated (SSFR) salivary flow rates, and by the visual analogue scale (VAS) regarding dry mouth-related symptoms. Statistical analyses were performed with repeated-measures using a mixed-effect modeling procedure and analysis of variance. An alpha level of 0.05 was accepted for statistical significance. Although all patients exhibited some degree of impairment in salivary gland functioning after RT, significant differences were found between the groups. Patients in the PA group showed improved salivary flow rates (RSFR, SSFR; p < 0.001) and decreased xerostomia-related symptoms (VAS, p < 0.05) compared with patients in the CT group. Although PA treatment did not prevent the oral sequelae of RT completely, it significantly minimized the severity of radiation-induced xerostomia. The results suggest that acupuncture focused in a preventive approach can be a useful therapy in the management of patients with head and neck cancer undergoing RT.
“…Xerostomia can result in long-term or even permanent oral function impairment and usually is associated with morbidity that profoundly affects the quality of life. [1][2][3][4] Several potential methods for preventing radiation-induced xerostomia have been described; however, xerostomia management is complex and often is refractory to most interventions. 5 Studies using systemic sialogogues (e.g., pilocarpine) concomitant with RT have failed to show significant maintenance of saliva production.…”
The aim of this study was to evaluate the effectiveness of acupuncture in minimizing the severity of radiation-induced xerostomia in patients with head and neck cancer. A total of 24 consecutive patients receiving > 5000 cGy radiotherapy (RT) involving the major salivary glands bilaterally were assigned to either the preventive acupuncture group (PA, n = 12), treated with acupuncture before and during RT, or the control group (CT, n = 12), treated with RT and not receiving acupuncture. After RT completion, clinical response was assessed in all patients by syalometry, measuring the resting (RSFR) and stimulated (SSFR) salivary flow rates, and by the visual analogue scale (VAS) regarding dry mouth-related symptoms. Statistical analyses were performed with repeated-measures using a mixed-effect modeling procedure and analysis of variance. An alpha level of 0.05 was accepted for statistical significance. Although all patients exhibited some degree of impairment in salivary gland functioning after RT, significant differences were found between the groups. Patients in the PA group showed improved salivary flow rates (RSFR, SSFR; p < 0.001) and decreased xerostomia-related symptoms (VAS, p < 0.05) compared with patients in the CT group. Although PA treatment did not prevent the oral sequelae of RT completely, it significantly minimized the severity of radiation-induced xerostomia. The results suggest that acupuncture focused in a preventive approach can be a useful therapy in the management of patients with head and neck cancer undergoing RT.
“…36,37 Using a rat model in this study, we showed that HSP25 and HSP70i protected radiation-induced submandibular damage and that this protective effect was attributable to inhibition of cell death and restoration of saliva fluid.…”
Irradiation (IR) is a fundamental treatment modality for head and neck malignancies. However, a significant drawback of IR treatment is irreversible damage of salivary gland in the IR field. In the present study, we investigated whether heat shock protein (HSP) 25 could be used as a radioprotective molecule for radiation-induced salivary gland damage in rats. HSP25 as well as inducible HSP70 (HSP70i) that were delivered to the salivary gland via an adenoviral vector significantly ameliorated radiation-induced salivary fluid loss. Radiation-induced apoptosis, caspase-3 activation, and poly(ADP-ribose) polymerase cleavage in acinar cells, granular convoluted cells, and intercalated ductal cells were also inhibited by HSP25 or HSP70i transfer. The alteration of salivary contents, including amylase, protein, Ca ؉ , Cl ؊ , and Na ؉ , was also attenuated by HSP25 transfer. Histological analysis revealed almost no radiation-induced damage in salivary gland when HSP25 was transferred. Aquaporin 5 expression in salivary gland was inhibited by radiation; and HSP25 transfer to salivary gland prevented this alteration. The protective effect of HSP70i on radiationinduced salivary gland damage was less or delayed than that of HSP25. These results indicate that HSP25 is a good candidate molecule to protect salivary gland from the toxicity
“…b Entwicklungsstö-rungen der Zähne nach Bestrahlung. Frontzähne überkront, Restbezahnung hypoplastisch und kariesanfällig eine geringe Speichelflussrate generell mit einem erhöhten Kariesrisiko assoziiert ist [2,12]. Diese Beobachtungen unterstützen die These, welche die Hyposalivation mitsamt ihren Folgen als Ursache für die rasche Zerstörung der Zähne bei bestrahlten Patienten sieht.…”
To enable optimal medical care of the patients during the time course of radiotherapy as well as afterwards, close interdisciplinary cooperation between radiotherapists, oral surgeons, otorhinolaryngologists, and dentists is absolutely essential.
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