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
Transdifferentiation of human amniotic epithelial cells into acinar cells using a double-chamber system.
TL;DR: Human amniotic epithelial cells (hAECs) possess the potential to differentiate into functional acinar cells (ACs) in vitro and might be a stem cell resource for clinical applications of cell replacement therapy in salivary gland dysfunction diseases.
Journal ArticleDOI
The impact of radiation caries in the quality of life of head and neck cancer patients
Mariana de Pauli Paglioni,Natália Rangel Palmier,Ana Carolina Prado-Ribeiro,Eduardo Rodrigues Fregnani,Maria Beatriz Duarte Gavião,Thaís Bianca Brandão,Márcio Ajudarte Lopes,Ana Paula Dias Ribeiro,Cesar A. Migliorati,Alan Roger Santos-Silva +9 more
TL;DR: RC had a negative impact on the QoL of HNC patients, and recreation and saliva, which belong to the physical function domain, showed a statistically significant difference between the study and control groups.
Journal ArticleDOI
‘Forbidden points’ in pregnancy: do they exist?
TL;DR: The small number of available publications on this topic seems to show that this is not correct, and animal research examining possible harmful effects and a systematic review would be welcome to throw some light on this question.
Journal ArticleDOI
Safety of contralateral submandibular gland sparing in locally advanced oropharyngeal cancers: A multicenter review
Tyler P. Robin,Gregory N. Gan,Moses Tam,David C. Westerly,Nadeem Riaz,Sana D. Karam,Nancy Y. Lee,David Raben +7 more
TL;DR: A large cohort of patients with locally advanced head and neck cancer that underwent contralateral submandibular gland‐sparing radiotherapy is presented, to demonstrate feasibility and safety specifically in patients with local advanced disease.
Journal ArticleDOI
Transient Activation of the Hedgehog-Gli Pathway Rescues Radiotherapy-Induced Dry Mouth via Recovering Salivary Gland Resident Macrophages
Qingguo Zhao,Linying Zhang,Bo Hai,Jun Wang,Courtney L. Baetge,Michael A. Deveau,Geoffrey M. Kapler,Jian Q. Feng,Fei Liu +8 more
TL;DR: It is shown in mice that activation of canonical Gli-dependent Hedgehog signaling by Gli1 gene transfer is sufficient to recover salivary function impaired by irradiation and reveal that resident macrophages and their prorepair paracrine factors are essential for the rescue of irradiation-impaired salivARY function by transient Hedgehog activation and are promising therapeutic targets of radiotherapy-induced irreversible dry mouth.
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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