A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life

Jensen, Siri Beier; Pedersen, Anne Marie Lynge; Vissink, Arjan; Andersen, Elo; Brown, Carlton G.; Davies, Andrew; Dutilh, J C; Fulton, Janet S.; Janković, Ljiljana; Lopes, Nilza Nelly Fontana; Mello, Ana Lúcia Schaefer Ferreira de; Muniz, L. V.; Murdoch‐Kinch, Carol Anne; Nair, Raj; Napeñas, Joel J.; Nogueira-Rodrigues, A.; Saunders, Deborah; Stirling, Bridget; Bültzingslöwen, Inger von; Weikel, Dianna; Elting, Linda S.; Spijkervet, Frederik; Brennan, Michael T.

doi:10.1007/s00520-010-0827-8

Cited by 383 publications

(346 citation statements)

References 197 publications

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“…Hyposalivation is a common acute and long-term complication of antineoplastic therapies of head and neck. 8,30 In HSCT-treated patients, radiotherapy is likely to be one etiological factor for hyposalivation. 9 Hypofunction of salivary glands depends on the cumulative dose to the gland tissue, and exposure to high total radiation doses (426-36 Gy) leads to a significant reduction of salivary secretion.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7] In addition, subjective symptoms of dry mouth (xerostomia), altered taste/vision, eating and speaking problems and sensation of a foreign body in the eye are common and known to have a significant impact on the QoL. 8 In a recent study, objectively determined hyposalivation was found in B50% of patients 6 months post-HSCT. 9 In most cases, stimulated saliva flow returned to normal levels within 2 years, but some patients suffered from persisting hyposalivation.…”

Section: Introductionmentioning

confidence: 99%

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Sicca symptoms and their impact on quality of life among very long-term survivors after hematopoietic SCT

Daikeler

Mauramo

Rovó

et al. 2013

Bone Marrow Transplant

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The objective of this prospective cross-sectional case-control study was to examine the prevalence of dryness symptoms and its impact on quality of life (QoL) among very long-term survivors after hematopoietic SCT (HSCT) in comparison with their respective sibling donors. Forty-four allogeneic HSCT recipients with a long-term survival (median: 17.5; range: 11-26 years) were included. Their respective, HLA-identical sibling donors served as controls. Clinical examinations included saliva flow rates (SFR) and the Schirmer's test. The presence of sicca symptoms of mouth, eyes and skin were inquired. The social functioning (SF)-36 questionnaire was applied. Recipients had lower (Po0.01) unstimulated and stimulated mean SFR than donors. Schirmer's test results o5 mm was found in 45% of the recipients in comparison with 27% of the donors (P ¼ 0.07). Xerostomia (34 vs 4 subjects), xerophtalmia (23 vs 3) and dry skin (32 vs 12) were reported more often by the recipients than donors (Po0.001). Sicca symptoms and their objective findings correlated with QoL. The mean SF-36 scores of the donors were significantly higher than those of the recipients for physical component summary. In conclusion, sicca symptoms are common amongst long-term survivors of HSCT and affect remarkably the QoL.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sicca symptoms and their impact on quality of life among very long-term survivors after hematopoietic SCT

Daikeler

Mauramo

Rovó

et al. 2013

Bone Marrow Transplant

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“…Xerostomia was the most common long-term toxicity reported in the literature. The prevalence can be high as 93% [2,26,27].…”

Section: Oral Radiation Toxicitymentioning

confidence: 99%

Trismus and reduced quality of life in patients with oral squamous cell carcinoma, who received post-operative radiotherapy alone or combined with chemotherapy

Galitis

Droukas

Tzakis

et al. 2017

Forum of Clinical Oncology

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Background Patients, who receive radiotherapy (RT) for head and neck cancer, develop chronic functional abnormalities and survive with reduced quality of life. Purpose We aimed to study patients with oral cancer, who received post-operative radiotherapy or chemoradiotherapy. Patients Ten patients (mean age 63.8 years) were included. Methods Oral mucositis, pain and xerostomia, maximum mouth opening (MMO) and functional abnormalities before and after RT were recorded. The 35 mm MMO or less was accepted as trismus. Patients completed the EORTC QLQ C-30 and Head/Neck35 questionnaires. Results Mean RT dose was 64.3 Gray. Six patients received chemoradiotherapy. Severe mucositis, pain and xerostomia were recorded in 6 and 5 patients respectively. MMO was reduced in all patients. The mean MMO (34 mm) reached the level of trismus. The total number of symptoms increased from 3.1 to 6.3 in C-30 and from 3.1 to 8.8 per patient in the H/N35. Severe fatigue, pain, limitations at work, weakness, sad feelings, family problems, sleeping problems, anorexia, financial difficulties, tense/irritable, constipation, nausea, vomiting and depression were most often reported with C-30. Most patients reported low to moderate quality of life. Severe oral, jaw and neck pain, swallowing problems, taste alterations, sticky saliva, dry mouth, coarseness, dental problems, feeling sick and reduced interest in life/sex were the most common symptoms reported with N/H35. Conclusions The observed trismus, 2- to 3-fold increase of symptoms and poorer quality of life highlighted the need for support of oral cancer patients, who receive postoperative radiotherapy or chemoradiotherapy.

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“…Like patients with pSS, these individuals experience a marked decline in quality of life (13,14). Although the ductal cells are still functional and can still generate an osmotic gradient (lumen > interstitium), the acinar cells are highly radiosensitive and represent the only water-permeable portion of the gland.…”

mentioning

confidence: 99%

Aquaporin gene therapy corrects Sjögren’s syndrome phenotype in mice

Lai

Yin

Cabrera-Pérez

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

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Primary Sjögren’s syndrome (pSS) is a chronic autoimmune disease that is estimated to affect 35 million people worldwide. Currently, no effective treatments exist for Sjögren’s syndrome, and there is a limited understanding of the physiological mechanisms associated with xerostomia and hyposalivation. The present work revealed that aquaporin 5 expression, a water channel critical for salivary gland fluid secretion, is regulated by bone morphogenetic protein 6. Increased expression of this cytokine is strongly associated with the most common symptom of primary Sjögren’s syndrome, the loss of salivary gland function. This finding led us to develop a therapy in the treatment of Sjögren’s syndrome by increasing the water permeability of the gland to restore saliva flow. Our study demonstrates that the targeted increase of gland permeability not only resulted in the restoration of secretory gland function but also resolved the hallmark salivary gland inflammation and systemic inflammation associated with disease. Secretory function also increased in the lacrimal gland, suggesting this local therapy could treat the systemic symptoms associated with primary Sjögren’s syndrome.

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A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life

Cited by 383 publications

References 197 publications

Sicca symptoms and their impact on quality of life among very long-term survivors after hematopoietic SCT

Sicca symptoms and their impact on quality of life among very long-term survivors after hematopoietic SCT

Trismus and reduced quality of life in patients with oral squamous cell carcinoma, who received post-operative radiotherapy alone or combined with chemotherapy

Aquaporin gene therapy corrects Sjögren’s syndrome phenotype in mice

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