Assessment of xerostomia and its impact on quality of life in head and neck cancer patients undergoing radiation therapy

Memtsa, Pinelopi-Theopisti; Tolia, Maria; Tzitzikas, Ioannis; Bizakis, John G.; Pistevou-Gombaki, Kyriaki; Charalambidou, Martha; Iliopoulou, Chrysoula; Kyrgias, G.

doi:10.3892/mco.2017.1200

Cited by 23 publications

(16 citation statements)

References 17 publications

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“…A significant correlation between salivary flow rate and xerostomia complaints was not found in our study, as agrees with others (25,29). Moreover, although xerostomia could have a significant effect on the quality of life (30), this potential effect might be underestimated, since in most studies questions regarding the presence of oral complaints were nonspecific. Studies on DTC patients that explicitly asked for xerostomia complaints reported a higher prevalence of these complaints than generally assumed by physicians (31).…”

Section: Discussionsupporting

confidence: 86%

Long-Term Effects of Radioiodine Treatment on Salivary Gland Function in Adult Survivors of Pediatric Differentiated Thyroid Carcinoma

et al. 2018

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Pediatric differentiated thyroid cancer (DTC) is a rare disease. Initial treatment of DTC consists of a total or near-total thyroidectomy and 131 I therapy. Previous studies on adults showed that 131 I treatment may reduce salivary gland function (SGF). Studies regarding SGF in children treated for DTC are sparse. Our aim was to assess the long-term effects of 131 I treatment on SGF in survivors of pediatric DTC. Methods: In a nationwide cross-sectional study, SGF in patients treated for pediatric DTC between 1970 and 2013 (.5 y after diagnosis, $18 y old at the time of evaluation) was studied. SGF was assessed by sialometry, sialochemistry, and a xerostomia inventory. Salivary gland dysfunction (SGD) was defined as an unstimulated whole saliva flow of no more than 0.2 mL/min or a stimulated whole saliva flow of no more than 0.7 mL/min. Results: Sixty-five patients underwent 131 I treatment (median age at evaluation, 33 y, with an interquartile range [IQR] of 25-40 y; 86.2% female; median follow-up period, 11 y, with an IQR of 6-22 y). Median cumulative 131 I activity was 5.88 GBq, with an IQR of 2.92-12.95 GBq, and 47.7% underwent multiple 131 I administrations. SGD was present in 30 (47.6%) patients. Levels of amylase and total protein in saliva were reduced. Moderate to severe xerostomia was present in 22 (35.5%) patients. Stimulated salivary secretion was lower and the severity of xerostomia complaints higher in patients treated with higher cumulative 131 I activity. Conclusion: In survivors of pediatric DTC, clinically significant SGD was found in 35.5% and was related to the cumulative 131 I activity of the treatment.

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Section: Discussionsupporting

confidence: 86%

Long-Term Effects of Radioiodine Treatment on Salivary Gland Function in Adult Survivors of Pediatric Differentiated Thyroid Carcinoma

et al. 2018

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“…It is estimated that at least 1-year of follow-up is required to determine the effect of RT on xerostomia [32]. Thus, the follow-up period in our present study may be considered as sufficient to provide adequate information in terms of xerostomia following RT.…”

Section: Discussionmentioning

confidence: 92%

Diffusion-weighted imaging as a follow-up modality for evaluation of major salivary gland function in nasopharyngeal carcinoma patients: a preliminary study

et al. 2020

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Purpose To investigate the value of diffusion-weighted imaging (DWI) in assessing dynamic changes of major salivary gland function during follow-up post radiotherapy (RT) in nasopharyngeal carcinoma (NPC) patients. Materials and methods 31 consecutive patients with pathologically confirmed NPC scheduled for RT underwent six routine follow-up MRI examinations including DWI sequence prior to (pre-RT) and 1, 3, 6, 9, and 12 months post RT. Mean apparent diffusion coefficient (ADC) values of bilateral parotid glands (PGs) and submandibular glands (SMGs) were measured. Objective measurement of salivary flow rate (SFR) under unstimulated (uSFR) and stimulated conditions (sSFR) as well as subjective xerostomia assessment according to a patient-rated questionnaire were conducted before each MRI. Variance analysis was used to evaluate dynamic changes of ADC, SFR and xerostomia questionnaire summary scores (XQ-sum) at different timepoints and the correlation between ADC and XQ-sum. Pearson's correlation test was used to evaluate the correlations between pre-and post-RT changes of ADC (ΔADC) and SFR (ΔSFR) or mean RT dose. Results At each timepoint, ADCs of PGs were significantly lower than of SMGs, uSFR was significantly lower than sSFR. For both PGs and SMGs, ADCpost-RT were all higher than ADCpre-RT, with significant differences. ADC1m-post-RT initially increased and changed little to ADC3m-post-RT, ADC6m-post-RT, ADC9m-post-RT, and ADC12m-post-RT, then gradually declined over time. The dynamic change trends of SFR were negatively paralleled to those of ADC, while that of XQ-sum was similar. Dose-response relationships were detected between salivary gland mean RT dose and ΔADC. In PGs, negative correlations between ΔsSFR9m-post-RT and ΔADC9m-post-RT, and ΔsSFR12m-post-RT and ΔADC12m-post-RT were detected. In SMGs, negative correlations between ΔsSFR12m-post-RT and ΔADC12m-post-RT, and ΔuSFR12m-post-RT and ΔADC12m-post-RT were also detected. The ADCs of patients with severe subjective xerostomia were significantly higher, while patients with moderate subjective xerostomia presented a tendency toward higher ADCs compared to those with mild xerostomia from 6 to 12 months post RT.

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“…9 Another different results observed in USA study conducted in 2006, as the primary tumor sites was in the oropharynx as (68%). 10 An agreement observed in study conducted in Greece (2017) included 60 patients, where half of them had laryngeal/hypopharyngeal cancer (28% and 2% respectively). 11 About half of patients (49%) received radiotherapy ≥70 GY, and concerning the chemotherapy (90%) of the patients didn't take chemotherapy, only 68% previously received chemotherapy.…”

Section: Discussionmentioning

confidence: 60%

“…Out of 63 Iranian patients participated in a study conducted in 2012, 43 patients (77.8%) were male with male: female ratio was 3.5:1. 10 Finally, higher results observed in Greece in a study conducted on 60 patients with head and neck cancer, as male represented 80% of them (48 patients) with male: female ratio was 4:1. 11…”

Section: Discussionmentioning

confidence: 87%

“…In Iran (2012), 63 head and neck cancer patients, give different results observed when chemoradiation used in 55 patients (87.3%), while RT alone used in 8 patients (12.7%) at doses of at least 25-30 GY with average received radiation doses was 53.9 GY. 10 In Greece (2017), 78.3% of patients with head and neck cancer had undergone chemotherapy in addition to radiotherapy. 11 which disagreed with our study.…”

Section: Discussionmentioning

confidence: 99%

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Acute xerostomia in head and neck radiotherapy

Al-Nuaimi

Al-Rawaq

Noori

et al. 2019

Int J Otorhinolaryngol Head Neck Surg

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Background: Xerostomia is a common complaint experienced with radiotherapy to the head and neck and it is caused by salivary glands dysfunction. Methods: Xerostomia is a common complaint experienced with radiotherapy to the head and neck and it is caused by salivary glands dysfunction. Results: The mean age was 51.69±13.7 years; 67% were men and 33% were women. Nasopharyngeal tumor and larynx cancer were the common tumors diagnosed (29% and 28% respectively), 78% of the tumors were squamous cell carcinoma and 53% of them in stage III. Most patients didn’t take chemotherapy during radiotherapy (90%), while 68% of them have previously received chemotherapy. The mean dose of radiotherapy used was 63.2±9.65 Gray. Post radiotherapy, the highest proportion diagnosed with xerostomia grade I (37%), while 21% of them were free of xerostomia. Female, negative past medical history, site, stage and dose of radiation were associated factors that increased prevalence of xerostomia. Conclusions: After radiotherapy, there is a high chance for developing xerostomia. Females, negative past medical history, advanced stage of tumor, high dose of radiation and site of tumor (oral, nasopharyngeal, and parotid) were significantly associated factors. Tumor site was a significant factor associated with the grade of xerostomia.

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Assessment of xerostomia and its impact on quality of life in head and neck cancer patients undergoing radiation therapy

Cited by 23 publications

References 17 publications

Long-Term Effects of Radioiodine Treatment on Salivary Gland Function in Adult Survivors of Pediatric Differentiated Thyroid Carcinoma

Long-Term Effects of Radioiodine Treatment on Salivary Gland Function in Adult Survivors of Pediatric Differentiated Thyroid Carcinoma

Diffusion-weighted imaging as a follow-up modality for evaluation of major salivary gland function in nasopharyngeal carcinoma patients: a preliminary study

Acute xerostomia in head and neck radiotherapy

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