Journal ArticleDOI
A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life
Siri Beier Jensen,Anne Marie Lynge Pedersen,Arjan Vissink,Elo Andersen,C. G. Brown,Andrew Davies,J. Dutilh,Janet S. Fulton,Ljiljana Janković,Nilza Nelly Fontana Lopes,A. L. S. Mello,L. V. Muniz,C. A. Murdoch-Kinch,Raj G. Nair,Joel J. Napeñas,A. Nogueira-Rodrigues,Deborah P. Saunders,B. Stirling,I. von Bültzingslöwen,Dianna Weikel,Linda S. Elting,Frederik Spijkervet,Michael T. Brennan +22 more
TLDR
Salivary gland hypofunction and xerostomia are induced by radiotherapy in the head and neck region depending on the cumulative radiation dose to the gland tissue, and treatment focus should be on optimized/new approaches to further reduce the doses to the parotids.Abstract:
This systematic review aimed to assess the literature for prevalence, severity, and impact on quality of life of salivary gland hypofunction and xerostomia induced by cancer therapies. The electronic databases of MEDLINE/PubMed and EMBASE were searched for articles published in English since the 1989 NIH Development Consensus Conference on the Oral Complications of Cancer Therapies until 2008 inclusive. Two independent reviewers extracted information regarding study design, study population, interventions, outcome measures, results and conclusions for each article. The inclusion criteria were met by 184 articles covering salivary gland hypofunction and xerostomia induced by conventional, 3D conformal radiotherapy or intensity-modulated radiotherapy in head and neck cancer patients, cancer chemotherapy, total body irradiation/hematopoietic stem cell transplantation, radioactive iodine treatment, and immunotherapy. Salivary gland hypofunction and xerostomia are induced by radiotherapy in the head and neck region depending on the cumulative radiation dose to the gland tissue. Treatment focus should be on optimized/new approaches to further reduce the dose to the parotids, and particularly submandibular and minor salivary glands, as these glands are major contributors to moistening of oral tissues. Other cancer treatments also induce salivary gland hypofunction, although to a lesser severity, and in the case of chemotherapy and immunotherapy, the adverse effect is temporary. Fields of sparse literature included pediatric cancer populations, cancer chemotherapy, radioactive iodine treatment, total body irradiation/hematopoietic stem cell transplantation, and immunotherapy.read more
Citations
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Clinical practice guidelines in oncology
William J. Gradishar,Benjamin O. Anderson,Ron Balassanian,Sarah L. Blair,Harold J. Burstein,Amy E. Cyr,Anthony D. Elias,William B. Farrar,Andres Forero,Sharon H. Giordano,Matthew P. Goetz,Lori J. Goldstein,Steven J. Isakoff,Janice A. Lyons,P. Kelly Marcom,Ingrid A. Mayer,Beryl McCormick,Meena S. Moran,Ruth O'Regan,Sameer A. Patel,Lori J. Pierce,Elizabeth C. Reed,Kilian E. Salerno,Lee S. Schwartzberg,Amy Sitapati,Karen L. Smith,Mary Lou Smith,Hatem Soliman,George Somlo,Melinda L. Telli,John H. Ward,Rashmi Kumar,Dorothy A. Shead +32 more
TL;DR: This manuscript focuses on the NCCN Guidelines Panel recommendations for the workup, primary treatment, risk reduction strategies, and surveillance specific to DCIS.
Journal ArticleDOI
Three-dimensional conformal radiotherapy (3D-CRT) versus intensity modulated radiation therapy (IMRT) in squamous cell carcinoma of the head and neck: a randomized controlled trial.
Tejpal Gupta,Jai Prakash Agarwal,Sandeep Jain,Reena Phurailatpam,Sadhana Kannan,Sarbani Ghosh-Laskar,Vedang Murthy,Ashwini Budrukkar,Ketayun A. Dinshaw,Kumar Prabhash,Pankaj Chaturvedi,Anil K. D'Cruz +11 more
TL;DR: IMRT significantly reduces the incidence and severity of xerostomia compared to 3D-CRT in curative-intent irradiation of head-neck squamous cell carcinoma of HNSCC.
Journal ArticleDOI
A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: management strategies and economic impact
Siri Beier Jensen,Anne Marie Lynge Pedersen,Arjan Vissink,Elo Andersen,Carlton G. Brown,Andrew Davies,J. Dutilh,Janet S. Fulton,Ljiljana Janković,Nilza Nelly Fontana Lopes,A. L. S. Mello,L. V. Muniz,C. A. Murdoch-Kinch,Raj G. Nair,Joel J. Napeñas,A. Nogueira-Rodrigues,Deborah P. Saunders,B. Stirling,I. von Bültzingslöwen,Dianna Weikel,Linda S. Elting,Fred K. L. Spijkervet,Michael T. Brennan,Salivary Gland Hypofunction,Xerostomia Section +24 more
TL;DR: There is evidence that salivary gland hypofunction and xerostomia induced by cancer therapies can be prevented or symptoms be minimized to some degree, depending on the type of cancer treatment.
Journal ArticleDOI
Salivary secretion in health and disease.
Anne Marie Lynge Pedersen,Christiane E. Sørensen,Gordon Proctor,Guy H. Carpenter,Jörgen Ekström +4 more
TL;DR: How various diseases and medical treatment including commonly prescribed medications and cancer therapies can affect salivary gland structure and function is focused on.
Enabling health care decisionmaking through clinical decision support and knowledge management
David F. Lobach,Gillian D Sanders,Tiffani J Bright,Anthony Wong,Ravi Dhurjati,Erin Bristow,Lori A. Bastian,Remy R Coeytaux,Gregory P. Samsa,Vic Hasselblad,John W Williams,Liz Wing,Michael Musty,Amy S Kendrick +13 more
TL;DR: Strong evidence shows that CDSSs/KMSs are effective in improving health care process measures across diverse settings using both commercially and locally developed systems.
References
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Journal ArticleDOI
Dose, volume, and function relationships in parotid salivary glands following conformal and intensity-modulated irradiation of head and neck cancer
TL;DR: Dose/volume/function relationships in the parotid glands are characterized by dose and volume thresholds, steep dose/response relationships when the thresholds are reached, and a maximal volume dependence parameter in the NTCP model.
Journal ArticleDOI
Final Results of the 94–01 French Head and Neck Oncology and Radiotherapy Group Randomized Trial Comparing Radiotherapy Alone With Concomitant Radiochemotherapy in Advanced-Stage Oropharynx Carcinoma
Fabrice Denis,Pascal Garaud,Etienne Bardet,Marc Alfonsi,Christian Sire,Thierry Germain,Philippe Bergerot,B. Rhein,Jacques Tortochaux,Gilles Calais +9 more
TL;DR: In this paper, the authors report the 5-year survival and late toxicity results of a randomized clinical trial, which showed a 3-year improvement in overall survival and locoregional control of stage III or IV oropharynx carcinoma, using concomitant radiochemotherapy (arm B), compared with standard radiotherapy (ARM A).
Journal ArticleDOI
Oral Sequelae of Head and Neck Radiotherapy
TL;DR: In this review, the radiation-induced changes in healthy oral tissues and the resulting clinical consequences are discussed.
Journal ArticleDOI
Xerostomia and its predictors following parotid-sparing irradiation of head-and-neck cancer
Avraham Eisbruch,Hyungjin Myra Kim,Jeffrey E. Terrell,Jeffrey E. Terrell,Lon H. Marsh,Laura A. Dawson,Jonathan A. Ship +6 more
TL;DR: An improvement over time in xerostomia, occurring in tandem with rising salivary production from the spared major Salivary glands, suggests a long-term clinical benefit from their sparing.
Journal ArticleDOI
Xerostomia and quality of life after intensity-modulated radiotherapy vs. conventional radiotherapy for early-stage nasopharyngeal carcinoma: initial report on a randomized controlled clinical trial.
Edmond H.N. Pow,Dora L.W. Kwong,Anne S. McMillan,May C. M. Wong,Jonathan S.T. Sham,Lucullus H.T. Leung,W. Keung Leung +6 more
TL;DR: IMRT was significantly better than CRT in terms of parotid sparing and improved QoL for early-stage disease and support the case for assessment of health-relatedQoL in relation to head-and-neck cancer using a site-specific approach.
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Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial.
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