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
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TLDR
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.Abstract:
This systematic review aimed to assess the literature for management strategies and economic impact of salivary gland hypofunction and xerostomia induced by cancer therapies and to determine the quality of evidence-based management recommendations. 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. For each article, two independent reviewers extracted information regarding study design, study population, interventions, outcome measures, results, and conclusions. Seventy-two interventional studies met the inclusion criteria. In addition, 49 intensity-modulated radiation therapy (IMRT) studies were included as a management strategy aiming for less salivary gland damage. Management guideline recommendations were drawn up for IMRT, amifostine, muscarinic agonist stimulation, oral mucosal lubricants, acupuncture, and submandibular gland transfer. 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. Management guideline recommendations are provided for IMRT, amifostine, muscarinic agonist stimulation, oral mucosal lubricants, acupuncture, and submandibular gland transfer. Fields of sparse literature identified included effects of gustatory and masticatory stimulation, specific oral mucosal lubricant formulas, submandibular gland transfer, acupuncture, hyperbaric oxygen treatment, management strategies in pediatric cancer populations, and the economic consequences of salivary gland hypofunction and xerostomia.read more
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Journal ArticleDOI
Adenovirus-mediated hAQP1 expression in irradiated mouse salivary glands causes recovery of saliva secretion by enhancing acinar cell volume decrease.
Leyla Teos,Changyu Zheng,Xibao Liu,William D. Swaim,CM Goldsmith,Ana P. Cotrim,B J Baum,Indu S. Ambudkar +7 more
TL;DR: Exposure to hAQP1 increases the water permeability of acinar cells, which underlies the recovery of fluid secretion in the salivary glands functionally compromised post IR, and is suggested to lead to significant recovery of saliva secretion and symptomatic relief in subjects.
Journal ArticleDOI
Two-year and lifetime cost-effectiveness of intensity modulated radiation therapy versus 3-dimensional conformal radiation therapy for head-and-neck cancer.
Racquel E. Kohler,Nathan C. Sheets,Stephanie B. Wheeler,Christopher M. Nutting,Emma Hall,Bhishamjit S. Chera +5 more
TL;DR: Although HNC patients receiving IMRT will likely experience reduced xerostomia and dysphagia symptoms, the small quality-of-life benefit associated with IMRT is not cost-effective in the short term but may be cost- effective over a patient's lifetime, assuming benefits persist over time and patients are healthy and likely to live for a sustained period.
Journal ArticleDOI
International field testing of the psychometric properties of an EORTC quality of life module for oral health: the EORTC QLQ-OH15
Marianne Jensen Hjermstad,Marianne Jensen Hjermstad,Mia Bergenmar,Kristin Bjordal,Sheila E. Fisher,Dirk Hofmeister,Sébastien Montel,Ourania Nicolatou-Galitis,Monica Pinto,Judith E. Raber-Durlacher,Susanne Singer,Iwona M. Tomaszewska,Krzysztof A. Tomaszewski,Irma M. Verdonck-de Leeuw,Noam Yarom,Noam Yarom,Julie Winstanley,Bente Brokstad Herlofson +17 more
TL;DR: The EORTC module QLQ-OH15 is a short, well-accepted assessment tool focusing on oral problems and QoL to improve clinical management and face and convergent validity and internal consistency were confirmed.
Journal ArticleDOI
Pro-apoptotic gene knockdown mediated by nanocomplexed siRNA reduces radiation damage in primary salivary gland cultures.
Szilvia Arany,Qingfu Xu,Eric Hernady,Danielle S. W. Benoit,Steve Dewhurst,Catherine E. Ovitt +5 more
TL;DR: It is successfully demonstrated that the siRNA/nanoparticle‐mediated knock down of pro‐apoptotic genes can prevent radiation‐induced damage in submandibular gland primary cell cultures.
Journal ArticleDOI
Complementary strategies for the management of radiation therapy side effects.
TL;DR: An overview of complementary and alternative medicine therapies that may alleviate some of the side effects of radiation therapy andTherapies that require more research or have been shown to be ineffective include aloe vera, glutamine, and deglycyrrhizinated licorice.
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
Phase III Randomized Trial of Amifostine as a Radioprotector in Head and Neck Cancer
David M. Brizel,Todd H. Wasserman,Michael Henke,Vratislav Strnad,Volkar Rudat,Alain Monnier,François Eschwege,Jay Zhang,Lesley Russell,Wolfgang Oster,Rolf Sauer +10 more
TL;DR: With and without amifostine, 2-year local-regional control, disease-free survival, and overall survival were 58% versus 63, 53% versus 57%, and 71% versus 66%, respectively, while Antitumor treatment efficacy was preserved.
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.
Journal ArticleDOI
Prospective Randomized Study of Intensity-Modulated Radiotherapy on Salivary Gland Function in Early-Stage Nasopharyngeal Carcinoma Patients
Michael K.M. Kam,Sing Fai Leung,Benny Zee,Ricky M. C. Chau,Joyce J. S. Suen,Frankie Mo,Maria Lai,Rosalie Ho,Kin Yin Cheung,Brian K.H. Yu,Samuel K.W. Chiu,Peter H.K. Choi,Peter M.L. Teo,Wing Hong Kwan,Anthony T.C. Chan +14 more
TL;DR: IMRT is superior to 2DRT in preserving parotid function and results in less severe delayed xerostomia in the treatment of early-stage NPC, which reflects the need to enhance protection of other salivary glands.
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