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

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Abstract

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.

Most cited references 62

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Head and neck cancer.

Athanassios Argiris, Michalis V. Karamouzis, David Raben … (2008)

Most head and neck cancers are squamous cell carcinomas that develop in the upper aerodigestive epithelium after exposure to carcinogens such as tobacco and alcohol. Human papillomavirus has also been strongly implicated as a causative agent in a subset of these cancers. The complex anatomy and vital physiological role of the tumour-involved structures dictate that the goals of treatment are not only to improve survival outcomes but also to preserve organ function. Major improvements have been accomplished in surgical techniques and radiotherapy delivery. Moreover, systemic therapy including chemotherapy and molecularly targeted agents--namely, the epidermal growth factor receptor inhibitors--has been successfully integrated into potentially curative treatment of locally advanced squamous-cell carcinoma of the head and neck. In deciding which treatment strategy would be suitable for an individual patient, important considerations include expected functional outcomes, ability to tolerate treatment, and comorbid illnesses. The collaboration of many specialties is the key for optimum assessment and decision making. We review the epidemiology, molecular pathogenesis, diagnosis and staging, and the latest multimodal management of squamous cell carcinoma of the head and neck.

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Saliva in health and disease: an appraisal and update.

L M Sreebny (2000)

Saliva plays an important role in oral health monitoring, regulating and maintaining the integrity of the oral hard tissues and some soft tissues. This paper reviews the role of saliva, the prevalence of oral dryness and the consequent importance of salivary flow as well as the relationship between xerostomia and salivary gland hypofunction amongst the causes of oral dryness. Other aspects of oral conditions associated with saliva are also reviewed including Sjögren's Syndrome and oesophageal function. Finally, knowledge, and the current use of salivary tests and the utilisation of saliva as a diagnostic fluid are surveyed.

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Xerostomia: clinical aspects and treatment.

S Turnbull, Juliana Cassolato (2003)

Xerostomia or dry mouth is a condition that is frequently encountered in dental practice. The most common cause is the use of certain systemic medications, which make the elderly at greater risk because they are usually more medicated. Other causes include high doses of radiation and certain diseases such as Sjogren's syndrome. Xerostomia is associated with difficulties in chewing, swallowing, tasting or speaking. This results in poor diet, malnutrition and decreased social interaction. Xerostomia can cause oral discomfort, especially for denture wearers. Patients are at increased risk of developing dental caries. A thorough intraoral and extra-oral clinical examination is important for diagnosis. Treatment may include the use of salivary substitutes (Biotene), salivary stimulants such as pilocarpine, ongoing dental care, caries prevention, a review of the current prescription drug regimen and possible elimination of drugs having anticholinergic effects. Because of the ageing population, and the concomitant increase in medicated individuals, dentists can expect to be presented with xerostomia in an increasing number of patients in the coming years and therefore should be familiar with its diagnosis and treatment. Therefore, the purpose of this review is to outline for clinicians the common aetiologies, clinical identification, and routine therapeutic modalities available for individuals with xerostomia.

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Author and article information

Journal

Journal ID (iso-abbrev): Ther Clin Risk Manag

Title: Therapeutics and clinical risk management

Publisher: Informa UK Limited

ISSN: 1176-6336

ISSN (Print): 1176-6336

Publication date (Electronic): 2015

Volume: 11

Affiliations

[1 ] Department of Biomedical Science, University of Sassari, Sassari, Italy.

[2 ] Department of Surgery, Microsurgery and Medicine, University of Sassari, Sassari, Italy.

[3 ] Department of Dental Science, University of Palermo, Palermo, Italy.

Article

Publisher Item ID: tcrm-11-171

DOI: 10.2147/TCRM.S70652

PMC ID: 4325830

PubMed ID: 25691810

SO-VID: 5526cb45-93bc-4579-8021-c3c57c8a2d0a

History

Keywords: salivary gland hypofunction,radiation-induced xerostomia,management strategies

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Keywords: salivary gland hypofunction, radiation-induced xerostomia, management strategies

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

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Abstract

Most cited references 62

Head and neck cancer.

Saliva in health and disease: an appraisal and update.

Xerostomia: clinical aspects and treatment.

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