Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage

BACKGROUND: The irradiation of head and neck cancer (HNC) often causes damage to the salivary glands. The resulting salivary gland hypofunction and xerostomia seriously reduce the patient’s quality of life. PURPOSE: To analyze the literature of actual management strategies for radiation-induced hypo...

Descripción completa

Detalles Bibliográficos
Autores principales: Pinna, Roberto, Campus, Guglielmo, Cumbo, Enzo, Mura, Ida, Milia, Egle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325830/
https://www.ncbi.nlm.nih.gov/pubmed/25691810
http://dx.doi.org/10.2147/TCRM.S70652
_version_ 1782356851774455808
author Pinna, Roberto
Campus, Guglielmo
Cumbo, Enzo
Mura, Ida
Milia, Egle
author_facet Pinna, Roberto
Campus, Guglielmo
Cumbo, Enzo
Mura, Ida
Milia, Egle
author_sort Pinna, Roberto
collection PubMed
description BACKGROUND: The irradiation of head and neck cancer (HNC) often causes damage to the salivary glands. The resulting salivary gland hypofunction and xerostomia seriously reduce the patient’s quality of life. PURPOSE: To analyze the literature of actual management strategies for radiation-induced hypofunction and xerostomia in HNC patients. METHODS: MEDLINE/PubMed and the Cochrane Library databases were electronically evaluated for articles published from January 1, 1970, to June 30, 2013. Two reviewers independently screened and included papers according to the predefined selection criteria. RESULTS: Sixty-one articles met the inclusion criteria. The systematic review of the literature suggests that the most suitable methods for managing the clinical and pathophysiological consequences of HNC radiotherapy might be the pharmacological approach, for example, through the use of cholinergic agonists when residual secretory capacity is still present, and the use of salivary substitutes. In addition, a modified diet and the patient’s motivation to enhance oral hygiene can lead to a significant improvement. CONCLUSION: Radiation-induced xerostomia could be considered a multifactorial disease. It could depend on the type of cancer treatment and the cumulative radiation dose to the gland tissue. A preventive approach and the correct treatment of the particular radiotherapeutic patient can help to improve the condition of xerostomia.
format Online
Article
Text
id pubmed-4325830
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Dove Medical Press
record_format MEDLINE/PubMed
spelling pubmed-43258302015-02-17 Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage Pinna, Roberto Campus, Guglielmo Cumbo, Enzo Mura, Ida Milia, Egle Ther Clin Risk Manag Review BACKGROUND: The irradiation of head and neck cancer (HNC) often causes damage to the salivary glands. The resulting salivary gland hypofunction and xerostomia seriously reduce the patient’s quality of life. PURPOSE: To analyze the literature of actual management strategies for radiation-induced hypofunction and xerostomia in HNC patients. METHODS: MEDLINE/PubMed and the Cochrane Library databases were electronically evaluated for articles published from January 1, 1970, to June 30, 2013. Two reviewers independently screened and included papers according to the predefined selection criteria. RESULTS: Sixty-one articles met the inclusion criteria. The systematic review of the literature suggests that the most suitable methods for managing the clinical and pathophysiological consequences of HNC radiotherapy might be the pharmacological approach, for example, through the use of cholinergic agonists when residual secretory capacity is still present, and the use of salivary substitutes. In addition, a modified diet and the patient’s motivation to enhance oral hygiene can lead to a significant improvement. CONCLUSION: Radiation-induced xerostomia could be considered a multifactorial disease. It could depend on the type of cancer treatment and the cumulative radiation dose to the gland tissue. A preventive approach and the correct treatment of the particular radiotherapeutic patient can help to improve the condition of xerostomia. Dove Medical Press 2015-02-04 /pmc/articles/PMC4325830/ /pubmed/25691810 http://dx.doi.org/10.2147/TCRM.S70652 Text en © 2015 Pinna et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Pinna, Roberto
Campus, Guglielmo
Cumbo, Enzo
Mura, Ida
Milia, Egle
Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage
title Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage
title_full Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage
title_fullStr Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage
title_full_unstemmed Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage
title_short Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage
title_sort xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325830/
https://www.ncbi.nlm.nih.gov/pubmed/25691810
http://dx.doi.org/10.2147/TCRM.S70652
work_keys_str_mv AT pinnaroberto xerostomiainducedbyradiotherapyanoverviewofthephysiopathologyclinicalevidenceandmanagementoftheoraldamage
AT campusguglielmo xerostomiainducedbyradiotherapyanoverviewofthephysiopathologyclinicalevidenceandmanagementoftheoraldamage
AT cumboenzo xerostomiainducedbyradiotherapyanoverviewofthephysiopathologyclinicalevidenceandmanagementoftheoraldamage
AT muraida xerostomiainducedbyradiotherapyanoverviewofthephysiopathologyclinicalevidenceandmanagementoftheoraldamage
AT miliaegle xerostomiainducedbyradiotherapyanoverviewofthephysiopathologyclinicalevidenceandmanagementoftheoraldamage