The efficacy of Xialine in patients with xerostomia resulting from radiotherapy for head and neck cancer (a pilot study)

Jellema, Anke Petra; Langendijk, Johannes A.; Bergenhengouwen, L; Reijden, WA van der; Leemans, CR; Smeele, Ludwig E.; Slotman, Ben J.

doi:10.1016/s0959-8049(99)81082-x

Cited by 21 publications

(34 citation statements)

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“…A variety of artificial saliva substitutes have been developed to supplement the reduced production of saliva, although very few have been evaluated appropriately. Obviously, because saliva is a complex substance with many functions, it is difficult to replace; therefore, saliva substitutes rarely are effective, and some patients find regular sips of water equally useful 97, 98. Moreover, artificial substitutes do not replace the antibacterial and immunologic protection of saliva and, thus, do not exclude the need for regular dental care and appropriate oral hygiene.…”

Section: Treatment Of Xerostomiamentioning

confidence: 99%

Radiation‐induced xerostomia in patients with head and neck cancer

Dirix

Nuyts²,

Bogaert³

2006

Cancer

345

271

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A dry mouth or xerostomia is one of the most common complications during and after radiotherapy for head and neck cancer, because irreparable damage is caused to the salivary glands, which are included in the radiation fields. Xerostomia not only significantly impairs the quality of life of potentially cured cancer patients, it may also lead to severe and long-term oral disorders. Because management of xerostomia is rarely effective, prevention is paramount. Several strategies have been developed to avoid radiation-induced salivary dysfunction without compromising definitive oncologic treatment. These include salivary gland-sparing radiation techniques, such as 3-dimensional conformal or intensity-modulated radiotherapy, concomitant cytoprotectants, and surgical salivary gland transfer. However, these preventive approaches are not applicable to all patients, and comprehensive scientific research that incorporates new biological insights is warranted to optimize the therapeutic index of radiotherapy for head and neck cancer. KEYWORDS: radiotherapy, head and neck, xerostomia, intensity-modulated radiotherapy.H ead and neck carcinoma (HNC) is the sixth most common cancer worldwide, accounting for 2.8% of all malignancies. In 2006, an estimated 39,250 Americans will develop HNC, and 11,090 deaths will occur. 1 Radiotherapy (RT) and surgery are the main treatment modalities, although there is an increasing role for chemotherapy. The choice of modality depends on patient factors, primary site, clinical stage, and resectability of the tumor. Approximately 30% to 40% of patients present with early-stage disease that is amendable to curative surgery or RT. More than 50% of patients present with locoregionally advanced disease at diagnosis. These patients can be treated with complete surgical excision followed by postoperative RT or with concomitant chemoradiotherapy. Despite this aggressive bimodality treatment approach, patients have a poor prognosis, with 5-year survival rates of 30% to 40%. 2,3 RT for definitive treatment of HNC is conventionally given in daily fractions of 1.8 grays (Gy) to 2.0 Gy, up to total doses of 66 Gy to 70 Gy over 6 or 7 weeks. 4 Recent evidence suggests that alterations in the fractionation schedule as well as concomitant chemotherapy may improve results significantly. 5,6 RT of the head and neck region causes both acute and long-term complications because of adverse effects on normal tissue. Frequently seen acute side-effects are mucositis, dysphagia, hoarseness, erythema, and desquamation of the skin. 7 Effective management of these complications is important, because they may interfere with compliance or cause treatment delays, resulting in loss of tumor control. 8 Late complications are chiefly the results of chronic injury to vasSupported by grants from the Vlaamse Liga tegen Kanker and the Klinisch Onderzoeksfonds.

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Section: Treatment Of Xerostomiamentioning

confidence: 99%

Radiation‐induced xerostomia in patients with head and neck cancer

Dirix

Nuyts²,

Bogaert³

2006

Cancer

345

271

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“…Salivary substitutes come in many shapes such as sprays, gels, oils, mouthwashes, or viscous liquids, and are viscous products to be applied to the oral mucosa [27]. The substitutes primary consist of carboxymethyl-cellulose, polyethylene oxide, or animal mucins with the cellulose-based being most common in sprays and gels [28]. For this study, the gel-based salvia substitute was based on hydroxypropyl methylcellulose and polyethylene oxide.…”

Section: Discussionmentioning

confidence: 99%

Reducing Late Dysphagia for Head and Neck Cancer Survivors with Oral Gel: A Feasibility Study

Kaae

Spejlborg

Spork³

et al. 2019

Dysphagia

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Dysphagia is a significant late morbidity following treatment with radiotherapy (RT) for head and neck squamous cell carcinomas (HNSCC). The purpose of this feasibility study was to test a gel-based saliva substitute to reduce the subjective assessment of dysphagia while eating food items varying in size and texture. Eligible study subjects treated with curative intended RT and suffering from dysphagia and xerostomia were recruited from the outpatient clinic during a two-month period. Nineteen subjects consented to participation and completed the EORTC QLQ-H&N35 questionnaire and three test meals. A Numeric Rating Scale (NRS) was used for subjective assessment of dysphagia during all test meals. All data on patient, tumor, and treatment characteristics were obtained from the Danish Head and Neck Cancer (DAHANCA) database. NRS data suggested reduction of dysphagia after application of the oral gel. The swallowing dysfunctions, discomfort while swallowing (p = 0.008), stuck food items (p = 0.02), and multiple attempts of clearing the throat (p = 0.05), improved significantly for soft and regular items. Both small-and large-sized food items were tested. EORTC QLQ-H&N35 showed improvement regarding eating problems (p = 0.03) and social eating (p = 0.02). No episodes of food aspiration were recorded during the test meals. Late dysphagia reduces QOL and is an important morbidity following RT. In this feasibility study, the oral gel was able to reduce dysphagia while eating soft and selected regular food items. Eating-related EORTC QLQ-H&N35 items also improved, indicating a beneficial reduction in dysphagia after application of the oral gel.

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“…Xerostomia can also interfere with patient compliance and may lead to treatment delays resulting in inadequate tumour control12; therefore, effective management is a priority. Current available methods to manage xerostomia include stringent oral hygiene with fluoride agents and antimicrobials, saliva substitutes, sialagogic agents13–21 and cytoprotective agents such as amifostine. Currently, the main treatment for xerostomia is medication such as pilocarpine and ceviline which are approved by the US Food and Drug Administration and are effective in promoting salivation and treating dry mouth.…”

Section: Introductionmentioning

confidence: 99%

Acupuncture for patients with cancer-induced xerostomia: a systematic review protocol

Tian

et al. 2019

BMJ Open

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IntroductionXerostomia is a common symptom in patients with cancer. Currently available methods to manage xerostomia include stringent oral hygiene using fluoride agents and antimicrobials, saliva substitutes and sialagogic agents, but side effects such as headache, dizziness and sweating can occur with these therapies. Clinical trials have shown that acupuncture may be effective in treating xerostomia. The objective of this systematic review is to assess the effectiveness and safety of acupuncture treatment for xerostomia caused by cancer.Methods and analysisThis systematic review will incorporate articles identified by electronically searching the following databases: PubMed, MEDLINE, the Cochrane Library, AMED, EMbase, WorldSciNet, Nature, Science Online, China National Knowledge Infrastructure, the Chongqing VIP Chinese Science and Technology Periodical Database, the Wanfang Database and China Biology Medicine Disc from inception to 1 December 2019. Other sources including conference proceedings and reference lists of identified publications and existing systematic reviews will also be searched. Two reviewers will independently search the databases, perform data extraction and assess the quality of studies. Data will be synthesised using either a fixed-effects model or a random-effects model, according to heterogeneity testing. Patient-reported change in the Visual Analogue Scale or the Xerostomia Inventory will be assessed as the primary outcome. Saliva collection, whole saliva production and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 will be evaluated as secondary outcomes. RevMan V. 5.3 will be employed for data analysis. The results will be expressed as risk ratios for dichotomous data and mean differences for continuous data.Ethics and disseminationThis protocol will not evaluate individual patient information or affect patient rights and therefore does not require ethical approval. Results from this review will be disseminated through peer-reviewed journals and conference reports.Trial registration numberCRD42019129069.

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The efficacy of Xialine in patients with xerostomia resulting from radiotherapy for head and neck cancer (a pilot study)

Cited by 21 publications

References 0 publications

Radiation‐induced xerostomia in patients with head and neck cancer

Radiation‐induced xerostomia in patients with head and neck cancer

Reducing Late Dysphagia for Head and Neck Cancer Survivors with Oral Gel: A Feasibility Study

Acupuncture for patients with cancer-induced xerostomia: a systematic review protocol

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