Radiotherapy-induced salivary dysfunction

Ship, Jonathan A.; Hu, K.

doi:10.1053/j.seminoncol.2004.12.009

Cited by 31 publications

(17 citation statements)

References 84 publications

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“…Historically, post-radiation lesions were presumed to be associated with salivary gland damage and the resultant hyposalivation; thus, the saliva glands, the parotid gland in particular, are considered in any radiation-sparing treatment using intensity modulated radiation therapy (IMRT) with or without the cytoprotectant amifostine [16,19,27,28]. Despite the salivary gland protection techniques, most patients remain susceptible to post-radiation dentition breakdown.…”

Section: Discussionmentioning

confidence: 99%

Post-radiation dental index: development and reliability

Walker

Williams

Wichman

2008

Support Care Cancer

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Section: Discussionmentioning

confidence: 99%

Post-radiation dental index: development and reliability

Walker

Williams

Wichman

2008

Support Care Cancer

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“…Salivary gland secretions maintain homeostasis of the upper gastrointestinal and oral cavity by generating a barrier to microbial, chemical, and mechanical insults (21,40,43). This primary function of saliva depends on numerous secretory proteins as well as the ion composition.…”

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confidence: 99%

Apical maxi-K (K_Ca1.1) channels mediate K⁺ secretion by the mouse submandibular exocrine gland

Nakamoto¹,

Romanenko²,

Takahashi³

et al. 2008

American Journal of Physiology-Cell Physiology

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The exocrine salivary glands of mammals secrete K+ by an unknown pathway that has been associated with HCO3− efflux. However, the present studies found that K+ secretion in the mouse submandibular gland did not require HCO3−, demonstrating that neither K+/HCO3− cotransport nor K+/H+ exchange mechanisms were involved. Because HCO3− did not appear to participate in this process, we tested whether a K channel is required. Indeed, K+ secretion was inhibited >75% in mice with a null mutation in the maxi-K, Ca2+-activated K channel (KCa1.1) but was unchanged in mice lacking the intermediate-conductance IKCa1 channel (KCa3.1). Moreover, paxilline, a specific maxi-K channel blocker, dramatically reduced the K+ concentration in submandibular saliva. The K+ concentration of saliva is well known to be flow rate dependent, the K+ concentration increasing as the flow decreases. The flow rate dependence of K+ secretion was nearly eliminated in K Ca 1.1 null mice, suggesting an important role for KCa1.1 channels in this process as well. Importantly, a maxi-K-like current had not been previously detected in duct cells, the theoretical site of K+ secretion, but we found that KCa1.1 channels localized to the apical membranes of both striated and excretory duct cells, but not granular duct cells, using immunohistochemistry. Consistent with this latter observation, maxi-K currents were not detected in granular duct cells. Taken together, these results demonstrate that the secretion of K+ requires and is likely mediated by KCa1.1 potassium channels localized to the apical membranes of striated and excretory duct cells in the mouse submandibular exocrine gland.

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“…While xerostomia is the most severe and most common side effect of RT, amifostine remains the only Turkiye Klinikleri J Med Sci 2012;32 (5) potent drug for preventing toxicity during longterm follow up. [27][28][29][30] Nonetheless, parotid sparing intensity modulated RT, which is reported to be superior to conventional RT and amifostine, resulted in a remarkable decrease in xerostomia. 31 The present study assessed the acute and late side effects of RT within weeks to months in patients who did and did not receive amifostine during conventional RT, and the results revealed a significant decrease in the development of xerostomia and fibrosis during the late follow-up period.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Amifostine on Acute and Late Radiation Side Effects in Head and Neck Cancer Patients

Demiroz¹,

Özkan²,

Cebelli³

et al. 2012

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : We aimed to investigate the effect of amifostine on acute and late side effects, and its tolerability in head and neck cancer patients treated with radiotherapy (RT). M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : The study included 87 patients with primary head and neck cancers and cervical lymph node metastases from unknown primary cancers treated with RT alone or combined with chemotherapy (CT). Forty-one patients (47%) received amifostine combined with RT (ART group) and 46 patients (52%) received RT without amifostine (RT group). The patients were evaluated every week during the treatment and at month 1 and 2 after the completion of RT for acute side effects and month 3, 6, 9, 12, and 24 after the treatment for late side effects according to SOMA/LENT scale. Amifostine was administered prior to RT, along with anti-emetic prophylaxis. The two groups were compared with the Student's t and MannWhitney U and Chi-square tests. R Re es su ul lt ts s: : The ART group had significantly less toxicity (grade 1 mucositis, grade 2 fibrosis) than patients in the RT group (p=0.001, p=0.03, respectively). At week 3 of RT grade 2 mucositis developed in two patients (5%) in the ART group and 10 patients (22%) in the RT group (p=0.02). The protective effect of amifostine on skin reactions developed at week 4 of RT (p=0.05). Grade 3 xerostomia at 9, 12, and 15 months of follow-up (p=0.02, p=0.02, and p=0.02, respectively), grade 2 xerostomia at 18 and 24 months (p=0.02 and p=0.01, respectively) and fibrosis at 15, 18 and 24 months (p=0.05, p=0.02 and p=0.02, respectively) decreased markedly in the ART group compared with the RT group. Emesis was the most common adverse effect of amifostine. C Co on nc cl lu us si io on n: : Daily administration of amifostine during RT was effective in avoiding late grade 2-3 xerostomia, as well as grade 2 fibrosis. K Ke ey y W Wo or rd ds s: : Radiotherapy; head and neck cancer; amifostine; xerostomia Ö ÖZ ZE ET T A Am ma aç ç: : Amifostinin radyoterapi (RT) ile tedavi edilmiş baş ve boyun kanseri hastalarında akut ve geç yan etkiler üzerindeki etkisini ve tolerabilitesini araştırmayı amaçladık. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışmaya, tek başına RT veya RT ve eş zamanlı kemoterapi (KT) ile tedavi edilmiş primer baş ve boyun kanseri olan ve primeri bilinmeyen bir kanserden servikal lenf düğümlerine metastaz yapmış 87 hasta dâhil edildi. Kırk bir hastaya (47%) RT ile birlikte amifostin (ART grup) ve 46 hastaya (52%) amifostin olmaksızın RT (RT grubu) verildi. Olgular, tedavi sırasında akut yan etkiler açısından her hafta ve RT bittikten sonra 1. ve 2. ayda, geç yan etkiler açısından ise tedavi bittikten sonra 3., 6., 9., 12., ve 24. aylarda SOMA/LENT skalasına göre değerlendirildiler. Amifostin RT'den önce antiemetik profilaksi ile beraber uygulandı. İki grubun, komplikasyonlar üzerindeki etki açısından karşılaştırılmasında Student-t ve Mann Whitney-u testleri kullanıldı. B Bu ul lg gu ul la ar r: : AR...

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Radiotherapy-induced salivary dysfunction

Cited by 31 publications

References 84 publications

Post-radiation dental index: development and reliability

Post-radiation dental index: development and reliability

Apical maxi-K (K_Ca1.1) channels mediate K⁺ secretion by the mouse submandibular exocrine gland

The Effect of Amifostine on Acute and Late Radiation Side Effects in Head and Neck Cancer Patients

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Radiotherapy-induced salivary dysfunction

Cited by 31 publications

References 84 publications

Post-radiation dental index: development and reliability

Post-radiation dental index: development and reliability

Apical maxi-K (KCa1.1) channels mediate K+ secretion by the mouse submandibular exocrine gland

The Effect of Amifostine on Acute and Late Radiation Side Effects in Head and Neck Cancer Patients

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Apical maxi-K (K_Ca1.1) channels mediate K⁺ secretion by the mouse submandibular exocrine gland