2018 ◽  
Vol 57 (04) ◽  
pp. 160-167 ◽  
Author(s):  
Sabine Haufe ◽  
Ralph Hohenberger ◽  
Matti Hein ◽  
Clemens Kratochwil ◽  
Hendrik Rathke ◽  
...  

Summary Introduction: Xerostomia following radioiodine therapy (RIT) in patients suffering from differentiated thyroid cancer is a common side effect in 2 % to 67 % of patients treated with radioiodine (I-131). In order to evaluate the impact of sialendoscopy on health related quality of life (HRQOL) in patients suffering from therapy induced sialadenitis and xerostomia, we analyzed findings from two dedicated questionnaires (Xerostomy Questionnaire XQ and Xerostomy Inventory XI) in patients before and three months after sialendoscopy. Procedures: In total, 12 patients suffering from differentiated thyroid carcinoma (10 women and 2 men) were evaluated. All patients had experienced conservative management. Patients were offered a sialendoscopy procedure if no major contradictions were present. Patients who denied the procedure formed the control group. Pre- and (three months) postoperative HRQOL was measured with the Patient Reported Outcome Measures (PROM) Xerostomia Questionnaire (XQ) and the Xerostomia Inventory (XI), as well as by a pre- and post-interventional salivary gland scintigram. Patients were graded according to their sialendoscopical findings. Results: Interventional group presented with significant improvements in HRQOL measurements regarding XQ and XI-scores three months postoperatively. Control group showed no significant changes in the XQ or the XI scores. Number of RIT and cumulative activity of I-131 did not correlate with higher disease grade in regards to sialendoscopical findings nor did it correlate with higher XQand XI scores. Pre- and post-interventional salivary gland scintigram stated that parotid glands are more severely damaged than submandibular glands (SMG), but no significant scintigraphically changes could be detected after sialendoscopy. Conclusion: Sialendoscopy in patients suffering from therapy induced sialadenitis and xerostomia seems to be beneficial when evaluating the impact on HRQOL. Functional parameters measured by salivary gland scintigram did not show significant changes in post-interventional scintigrams.


2017 ◽  
Vol 2 (3) ◽  
pp. 256 ◽  
Author(s):  
Manu Krishnan ◽  
Satish R Iyer ◽  
Kanti Lal Chakraborti ◽  
Saraswathy Seema ◽  
Tarun Sekhri

Radiation induced xerostomia is a persistent clinical presentation that affects the quality of life in head and neck cancer patients even with the best of the intensity modulated radiotherapy protocols. Comprehensive review of the anatomic, histologic, developmental and neuronal entities of salivary glands from a regenerative perspective, ensuing radiation is taken. It also evaluates the systemic and glandular radiation responses that form the early and late clinical changes. From these, the article submits probable strategies; based on the current knowledge and future challenges involved, in reversing radiation induced xerostomia. Further, it elaborates on the status of radioprotectors and mitigators including the recently reported biologic and chemical derivatives and proposes the rationale of using combination radioprotector therapy in radiation injuries. A brief of palliative regimes, alternate treatment modes and technologic advancements in radiotherapy are also explained. Salivary gland histologic components, which need to be protected in the emerging radiotherapy protocols and can be targeted in different salivary gland regeneration therapies is highlighted. The paper contributes to an improved understanding in radiation induced xerostomia and deliberates on novel mechanisms towards enhancing quality of life in head and neck cancer radiotherapy patients.


2016 ◽  
Vol 130 (8) ◽  
pp. 755-762 ◽  
Author(s):  
G B Morand ◽  
J Madana ◽  
S D Da Silva ◽  
M Roskies ◽  
K Sultanem ◽  
...  

AbstractObjectives:Salivary gland transfer surgery can reduce xerostomia in oropharyngeal squamous cell carcinoma patients undergoing primary chemoradiation. A potential drawback of salivary gland transfer is the treatment delay associated with the surgery, and its complications. This study aimed to determine whether the treatment delay affects patient survival and to evaluate patient quality of life after salivary gland transfer.Methods:A retrospective analysis of 138 patients (salivary gland transfer group, n = 58; non-salivary gland transfer group, n = 80) was performed. Patient survival was compared between these groups using multivariate analysis. Salivary gland transfer patients were further evaluated for surgical complications and for quality of life using the head and neck module of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire.Results:Salivary gland transfer and non-salivary gland transfer patients had comparable baseline clinical characteristics. Salivary gland transfer patients experienced a median treatment delay of 16.5 days before chemoradiation (p = 0.035). Multivariate analysis showed that this did not, however, correspond to a survival disadvantage (p = 0.24 and p = 0.97 for disease-free and disease-specific survival, respectively). A very low complication rate was reported for the salivary gland transfer group (1.7 per cent). Questionnaire scores for the item ‘xerostomia’ were very low in salivary gland transfer patients.Conclusion:The treatment delay associated with salivary gland transfer surgery does not negatively affect patient survival. Oropharyngeal squamous cell patients have an excellent quality of life after salivary gland transfer.


2021 ◽  
Author(s):  
Ziyad S. Haidar

Saliva has a critical role in the maintenance of oral, dental and general health and well-being. Alteration(s) in the amount/quantity and/or quality of secreted saliva may induce the development of several oro-dental variations, thereby negatively-impacting overall quality of life. Diverse factors may affect the process of saliva production and quantity/quality of secretion, including medications, systemic or local pathologies and/or reversible/irreversible damage. Indeed, chemo- and/or radio-therapy, particularly, in cases of head and neck cancer, for example, are well-documented to induce serious damage and dysfunction to the radio-sensitive salivary gland tissue, resulting in hypo-salivation, xerostomia (dry mouth) as well as numerous other adverse intra−/extra-oral, medical and quality-of-life issues. Although a single governing mechanism of radiation-induced salivary gland tissue damage and dysfunction has not been yet elucidated, the potential for a synergy in radio-protection (mainly, and possible -reparation) via a combinatorial approach of mechanistically distinct strategies, has been suggested and explored over the years. This is, undoubtfully, in parallel to the ongoing efforts in improving the precision, safety and efficacy of radiotherapy protocols/outcomes, as well as in developing new technological and pharmaceutical alternatives, topics covered in this chapter.


2018 ◽  
Vol 275 (4) ◽  
pp. 997-1003 ◽  
Author(s):  
Christoph Becker ◽  
Jens Pfeiffer ◽  
Kitty Lange ◽  
Kilian Konrad Kenjiro Dahlem

1987 ◽  
Vol 66 (2_suppl) ◽  
pp. 699-702 ◽  
Author(s):  
W.E. Wright

The purpose of this paper is to enumerate and describe the oral complications that are associated with salivary gland dysfunction. The significance of these oral problems and their related adverse impact on the patient's quality of life are presented. Palliative and therapeutic agents and regimens are discussed, and a suggested protocol for managing the deleterious oral sequelae of salivary gland dysfunction is outlined.


2009 ◽  
Vol 88 (10) ◽  
pp. 894-903 ◽  
Author(s):  
O. Grundmann ◽  
G.C. Mitchell ◽  
K.H. Limesand

Radiation therapy for head and neck cancer causes significant secondary side-effects in normal salivary glands, resulting in diminished quality of life for these individuals. Salivary glands are exquisitely sensitive to radiation and display acute and chronic responses to radiotherapy. This review will discuss clinical implications of radiosensitivity in normal salivary glands, compare animal models used to investigate radiation-induced salivary gland damage, address therapeutic advances, and project future directions in the field.


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