Effects of transcutaneous electrical nerve stimulation on the salivary flow of patients with hyposalivation induced by radiotherapy in the head and neck region—A randomised clinical trial

Paim, Émille Dalbem; Berbert, Monalise Costa Batista; Zanella, Virgílio Gonzales; Martins, Vera Beatris; Macagnan, Fabrí­cio Edler

doi:10.1111/joor.12851

Cited by 21 publications

(19 citation statements)

References 30 publications

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“…Two RCTs assessed the effects of TENS on radiation-induced xerostomia (RIX) in HNC patients (total n = 124 patients), both of which were good quality 99,100 . A preventive study by Wong et al 100 assessed acupuncture-like TENS after each radiation session versus standard care and found no subjective or objective improvement in xerostomia.…”

Section: Resultsmentioning

confidence: 99%

“…Two RCTs assessed the effects of TENS on radiationinduced xerostomia (RIX) in HNC patients (total n = 124 patients), both of which were good quality. 99,100 A preventive study by Wong et al 100 assessed acupuncture-like TENS after each radiation session versus standard care and found no subjective or objective improvement in xerostomia. However, the restorative study by Dalbem Paim et al 99 assessing TENS application on salivary glands compared with standard xerostomia management found improved subjective and objective salivary flow up to 6 mos after radiation therapy.…”

Section: And Body Composition (4)mentioning

confidence: 99%

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Rehabilitation Interventions in Head and Neck Cancer

Cheng,

Ramos Emos,

Leite

et al. 2024

Am J Phys Med Rehabil

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Objective The aim of the study is to identify and appraise current evidence for rehabilitation interventions in head and neck cancer. Design A previously published scoping review spanning 1990 through April 2017 was updated through January 11, 2023 and narrowed to include only interventional studies (Arch Phys Med Rehabil. 2019;100(12):2381–2388). Included studies had a majority head and neck cancer population and rehabilitation-specific interventions. Pairs of authors extracted data and evaluated study quality using the PEDro tool. Results were organized by intervention type. Results Of 1338 unique citations, 83 studies with 87 citations met inclusion criteria. The median study sample size was 49 (range = 9–399). The most common interventions focused on swallow (16 studies), jaw (11), or both (6), followed by whole-body exercise (14) and voice (10). Most interventions took place in the outpatient setting (77) and were restorative in intent (65 articles). The overall study quality was fair (median PEDro score 5, range 0–8); none were of excellent quality (PEDro >9). Conclusions Most head and neck cancer rehabilitation interventions have focused on restorative swallow and jaw exercises and whole-body exercise to address dysphagia, trismus, and deconditioning. More high-quality evidence for head and neck cancer rehabilitation interventions that address a wider range of impairments and activity and social participation limitations during various cancer care phases is urgently needed to reduce head and neck cancer-associated morbidity.

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Section: Resultsmentioning

confidence: 99%

Section: And Body Composition (4)mentioning

confidence: 99%

Rehabilitation Interventions in Head and Neck Cancer

Cheng,

Ramos Emos,

Leite

et al. 2024

Am J Phys Med Rehabil

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“…This category refers to treatments different than systemic or local agents, which included the use of transcutaneous stimulation ( 30 , 31 ) and low-level laser therapy (LLLT) ( 32 ). Wong et al .…”

Section: Resultsmentioning

confidence: 99%

“…TENS was applied bilaterally on submandibular and parotid glands, 20 minutes per sessions, twice a week, for 4 weeks. The authors reported a significant increase in salivary flow rate and OHRQoL ( 30 ). Fidelix et al .…”

Section: Resultsmentioning

confidence: 99%

Treatment alternatives for dry mouth: A scoping review

Niklander¹,

Martínez²,

Miranda³

et al. 2022

J Clin Exp Dent

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Background Saliva is a biological fluid essential for the maintenance of a proper oral health. Its absence predisposes to differences pathologies, including dental caries, fungal infections among many others, significantly affecting the oral health related quality of life (OHRQoL). There is a large variety of treatment alternatives available for dry mouth, which increases constantly. Objective: To identify new treatment alternatives for dry mouth. Material and Methods We conducted a systematic search in PubMed/MEDLINE, Web of Science, Scopus and Ebsco. Articles published between January 2015 and January 2020 were retrieved and reviewed by two independent evaluators. Results Nineteen studies met the inclusion criteria and were included for analysis. Local therapies were the most evaluated agents, followed by systemic and non-conventional treatments. Most local therapies showed certain utility for the management of dry mouth and the improvement of OHRQoL. These formulations were mainly based on natural agents, including malic acid, thyme honey, ginger, among others. Conclusions Local agents are first line treatment alternatives for dry mouth sensation, with a reported efficiency that varies between studies, and with a low number of reported adverse side-effects. Nevertheless, care must be taken when interpreting these results, as is difficult to compare studies within each other due large heterogeneity in study design and outcomes being measured. Key words: Xerostomia, dry mouth, hyposalivation, saliva, mouth dryness.

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“…Three RCTs assessed the use of transcutaneous electrostimulation or acupuncture-like transcutaneous electrostimulation in patients with salivary gland hypofunction or xerostomia induced by radiation therapy (Data Supplement). One RCT 40 (N = 68) evaluated the efficacy of TENS on hyposalivation compared with a control group receiving standard care (no intervention) and found a statistically significant long-term improvement in stimulated whole saliva flow rate in the experimental group compared with the control group. A second RCT 85 (N = 148) compared acupuncture-like transcutaneous stimulation (ALTENS) with pilocarpine for relieving radiation-induced xerostomia in patients with head and neck cancer showing no significant difference between the two groups.…”

Section: Recommendationsmentioning

confidence: 99%

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

Mercadante

Jensen

Smith

et al. 2021

JCO

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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 .

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Effects of transcutaneous electrical nerve stimulation on the salivary flow of patients with hyposalivation induced by radiotherapy in the head and neck region—A randomised clinical trial

Cited by 21 publications

References 30 publications

Rehabilitation Interventions in Head and Neck Cancer

Rehabilitation Interventions in Head and Neck Cancer

Treatment alternatives for dry mouth: A scoping review

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

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