scholarly journals On approaches to the functional restoration of salivary glands damaged by radiation therapy for head and neck cancer, with a review of related aspects of salivary gland morphology and development

2008 ◽  
Vol 83 (3-4) ◽  
pp. 103-130 ◽  
Author(s):  
RS Redman
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Salivary Gland ◽  
Head And Neck ◽  
Salivary Glands ◽  
Neck Cancer ◽  
Functional Restoration

scholarly journals Reducing Xerostomia by Comprehensive Protection of Salivary Glands in Intensity-Modulated Radiation Therapy with Helical Tomotherapy Technique for Head-and-Neck Cancer Patients: A Prospective Observational Study

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Feng Teng ◽  
Wenjun Fan ◽  
Yanrong Luo ◽  
Zhongjian Ju ◽  
Hanshun Gong ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Salivary Glands ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Helical Tomotherapy ◽  
Clinical Stage ◽  
Flow Rates ◽  
Saliva Flow

Objective. This study aimed to analyze the effects of comprehensive protection of bilateral parotid glands (PG-T), contralateral submandibular gland (cSMG), and accessory salivary glands in the oral cavity (OC) by helical tomotherapy for head-and-neck cancer patients. Methods. Totally 175 patients with histologically confirmed head-and-neck cancer treated with helical tomotherapy were recruited. The doses delivered to PG-T, cSMG, and OC were constrained to be as low as possible in treatment planning. The saliva flow rates and xerostomia questionnaire were evaluated. Correlation between xerostomia and other clinical factors were assessed using univariate and multivariate models. The impact of salivary gland dose on locoregional (LR) recurrence was assessed by Cox analysis. ROC curve was used to determine the threshold of mean dose for each gland. Results. The median follow-up was 25 (19–36) months. The OC mean dose, PG-T mean dose, cSMG mean dose, age, clinical stage (II and III versus IV), and both unstimulated and stimulated saliva flow rates were significantly correlated with xerostomia. The OC mean dose, cSMG mean dose, age, and clinical stage were predictors of xerostomia after adjusting PG-T mean dose, and unstimulated and stimulated saliva flow rates. Xerostomia was significantly decreased when the mean doses of PG-T, cSMG, and OC were kept below 29.12Gy, 29.29Gy, and 31.44Gy, respectively. At 18 months after radiation therapy, early LR recurrence rate was only 4%. Conclusion. Comprehensive protection of salivary glands minimized xerostomia in head-and-neck cancer patients treated by helical tomotherapy, without increasing early LR recurrence risk.

SU-D-204-04: Correlations Between Dosimetric Indices and Follow-Up Data for Salivary Glands Six Months After Radiation Therapy for Head and Neck Cancer

2016 ◽  
Vol 43 (6Part3) ◽  
pp. 3332-3333
Author(s):  
B Chera ◽  
A Price ◽  
M Kostich ◽  
R Amdur ◽  
W Mendenhall ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Salivary Glands ◽  
Neck Cancer ◽  
Dosimetric Indices

scholarly journals Salivary Gland Hypofunction and/or Xerostomia Induced by Nonsurgical Cancer Therapies: ISOO/MASCC/ASCO Guideline

2021 ◽  
pp. JCO.21.01208
Author(s):  
Valeria Mercadante ◽  
Siri Beier Jensen ◽  
Derek K. Smith ◽  
Kari Bohlke ◽  
Jessica Bauman ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Salivary Gland ◽  
Head And Neck ◽  
Neck Cancer ◽  
Cancer Therapies ◽  
Saliva Substitutes ◽  
Salivary Gland Hypofunction ◽  
Tissue Sparing ◽  
Quality Evidence

PURPOSE To provide evidence-based recommendations for prevention and management of salivary gland hypofunction and xerostomia induced by nonsurgical cancer therapies. METHODS Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) and ASCO convened a multidisciplinary Expert Panel to evaluate the evidence and formulate recommendations. PubMed, EMBASE, and Cochrane Library were searched for randomized controlled trials published between January 2009 and June 2020. The guideline also incorporated two previous systematic reviews conducted by MASCC/ISOO, which included studies published from 1990 through 2008. RESULTS A total of 58 publications were identified: 46 addressed preventive interventions and 12 addressed therapeutic interventions. A majority of the evidence focused on the setting of radiation therapy for head and neck cancer. For the prevention of salivary gland hypofunction and/or xerostomia in patients with head and neck cancer, there is high-quality evidence for tissue-sparing radiation modalities. Evidence is weaker or insufficient for other interventions. For the management of salivary gland hypofunction and/or xerostomia, intermediate-quality evidence supports the use of topical mucosal lubricants, saliva substitutes, and agents that stimulate the salivary reflex. RECOMMENDATIONS For patients who receive radiation therapy for head and neck cancer, tissue-sparing radiation modalities should be used when possible to reduce the risk of salivary gland hypofunction and xerostomia. Other risk-reducing interventions that may be offered during radiation therapy for head and neck cancer include bethanechol and acupuncture. For patients who develop salivary gland hypofunction and/or xerostomia, interventions include topical mucosal lubricants, saliva substitutes, and sugar-free lozenges or chewing gum. For patients with head and neck cancer, oral pilocarpine and oral cevimeline, acupuncture, or transcutaneous electrostimulation may be offered after radiation therapy. Additional information can be found at www.asco.org/supportive-care-guidelines .

scholarly journals Aldehyde dehydrogenase 3A1 activation prevents radiation-induced xerostomia by protecting salivary stem cells from toxic aldehydes

2018 ◽  
Vol 115 (24) ◽  
pp. 6279-6284 ◽  
Author(s):  
Julie P. Saiki ◽  
Hongbin Cao ◽  
Lauren D. Van Wassenhove ◽  
Vignesh Viswanathan ◽  
Joshua Bloomstein ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Salivary Glands ◽  
Aldehyde Dehydrogenase ◽  
Neck Cancer ◽  
Common Side Effect ◽  
Loss Of Function ◽  
And Function

Xerostomia (dry mouth) is the most common side effect of radiation therapy in patients with head and neck cancer and causes difficulty speaking and swallowing. Since aldehyde dehydrogenase 3A1 (ALDH3A1) is highly expressed in mouse salivary stem/progenitor cells (SSPCs), we sought to determine the role of ALDH3A1 in SSPCs using genetic loss-of-function and pharmacologic gain-of-function studies. Using DarkZone dye to measure intracellular aldehydes, we observed higher aldehyde accumulation in irradiated Aldh3a1−/− adult murine salisphere cells and in situ in whole murine embryonic salivary glands enriched in SSPCs compared with wild-type glands. To identify a safe ALDH3A1 activator for potential clinical testing, we screened a traditional Chinese medicine library and isolated d-limonene, commonly used as a food-flavoring agent, as a single constituent activator. ALDH3A1 activation by d-limonene significantly reduced aldehyde accumulation in SSPCs and whole embryonic glands, increased sphere-forming ability, decreased apoptosis, and improved submandibular gland structure and function in vivo after radiation. A phase 0 study in patients with salivary gland tumors showed effective delivery of d-limonene into human salivary glands following daily oral dosing. Given its safety and bioavailability, d-limonene may be a good clinical candidate for mitigating xerostomia in patients with head and neck cancer receiving radiation therapy.

Salivary Gland Hypofunction and Xerostomia in Head and Neck Radiation Patients

2019 ◽  
Vol 2019 (53) ◽  
Author(s):  
Siri Beier Jensen ◽  
Arjan Vissink ◽  
Kirsten H Limesand ◽  
Mary E Reyland
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Salivary Gland ◽  
Head And Neck ◽  
Neck Cancer ◽  
Radiation Injury ◽  
Salivary Gland Tissue ◽  
Gland Tissue ◽  
Salivary Gland Hypofunction ◽  
Gland Function

AbstractBackgroundThe most manifest long-term consequences of radiation therapy in the head and neck cancer patient are salivary gland hypofunction and a sensation of oral dryness (xerostomia).MethodsThis critical review addresses the consequences of radiation injury to salivary gland tissue, the clinical management of salivary gland hypofunction and xerostomia, and current and potential strategies to prevent or reduce radiation injury to salivary gland tissue or restore the function of radiation-injured salivary gland tissue.ResultsSalivary gland hypofunction and xerostomia have severe implications for oral functioning, maintenance of oral and general health, and quality of life. Significant progress has been made to spare salivary gland function chiefly due to advances in radiation techniques. Other strategies have also been developed, e.g., radioprotectors, identification and preservation/expansion of salivary stem cells by stimulation with cholinergic muscarinic agonists, and application of new lubricating or stimulatory agents, surgical transfer of submandibular glands, and acupuncture.ConclusionMany advances to manage salivary gland hypofunction and xerostomia induced by radiation therapy still only offer partial protection since they are often of short duration, lack the protective effects of saliva, or potentially have significant adverse effects. Intensity-modulated radiation therapy (IMRT), and its next step, proton therapy, have the greatest potential as a management strategy for permanently preserving salivary gland function in head and neck cancer patients.Presently, gene transfer to supplement fluid formation and stem cell transfer to increase the regenerative potential in radiation-damaged salivary glands are promising approaches for regaining function and/or regeneration of radiation-damaged salivary gland tissue.

scholarly journals Evaluation of Protective Effect of Propolis on Parotid Salivary Glands in Gamma-irradiated Rats

2014 ◽  
Vol 15 (1) ◽  
pp. 8-11 ◽  
Author(s):  
Mina Motallebnejad ◽  
Seyed Mohammad Abedi ◽  
M Seyedmajidi ◽  
AA Moghadamnia ◽  
M Ashrafpour ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Salivary Gland ◽  
Protective Effect ◽  
Head And Neck ◽  
Salivary Glands ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Albino Rats ◽  
Significant Difference ◽  
Gamma Irradiated

ABSTRACT Objective and background One of the most significant side effects of radiotherapy for head and neck cancers is xerostomia as a result of salivary gland damage. Considering pharmacological effects of propolis, we evaluated its protective effect on salivary glands subjected to radiotherapy of head and neck cancer patients. Materials and methods Twenty-one male albino rats (8-11 W, 190 ± 5 gm) were divided into three groups of seven animals. Scintigraphy was performed in all the groups. Then groups 1 (S) and 2 (SR) received normal saline injections and group 3 (PR) received propolis injection over 3 days. After that groups 2 and 3 were exposed to gamma radiation and all the rats underwent scintigraphic assessment on third day and 70th day after irradiation. The lips and tongues of rats in groups 2 and 3 were examined for mucositis daily in first 10 days. At the end, the parotid glands of all rats were examined histologically. Results Scintigraphy results of third and 70th day after irradiation showed statistically significant differences between PR and SR as well as SR and S. However, there was no significant difference between the PR and S groups. Histopathologic assessment demonstrated significant difference between SR, PR and S. Conclusion These results suggest that propolis has protective effects on salivary gland function in animal models whilst it did not prevent radiation-induced histologic changes in tissues. Further investigations are needed to elucidate mechanisms of propolis actions. Clinical significance Regarding to the results of this study, propolis may be useful in reduction xerostomia due to radiation to salivary glands and may be helpful for head and neck cancer patients. How to cite this article Motallebnejad M, Abedi SM, Seyedmajidi M, Moghadamnia AA, Ashrafpour M, Salehi M, Moslemi D, Ghorbani A. Evaluation of Protective Effect of Propolis on Parotid Salivary Glands in Gamma-irradiated Rats. J Contemp Dent Pract 2014;15(1):8-11.

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