Recent advances in prevention and treatment of post-radiotherapy xerostomia in patients with head and neck cancer

Abstract

Xerostomia or feeling of dry mouth is the most common (80%) of all complications of radiotherapy for head and neck cancer. Besides well-known artificial saliva and agents and therapies stimulating saliva production and salivary gland regeneration, new methods comprise the use of vitamins C and E, low-level laser therapy, hyperbaric oxygen therapy and thyme honey. Recently, transplantation of the mesenchymal stem cells was reported to be successful, and these may be, together with gene-transfer therapy the future therapies of xerostomia after salivary gland irradiation.

Efficacy of photobiomodulation therapy combined with mobile health education in patients with head and neck cancer suffering from chronic xerostomia after radiotherapy: protocol for a three-arm, randomised, placebo-controlled, double-blinded study

“… 14 However, the evidence on the benefits of pharmacological treatments, such as the procholinergic drug pilocarpine, which is used for the chemical stimulation of salivary secretions, is of low quality; this treatment has only minor effects and is accompanied by several unpleasant systemic adverse effects. 15 Furthermore, this approach has been associated with contraindications that limit its use. 16 17 Therefore, new methods have been gaining prominence as alternatives to pharmacological methods.…”

“…Even mesenchymal stem cell and gene transfer therapies have been proposed, although they have not yet been sufficiently investigated. 15 18 19 Although the mechanics of photobiomodulation (PBM) are still not fully understood, the evidence suggests that this therapy can modulate the functional capacity of the glandular parenchyma, inducing salivary production. 20 The main advantage of this physical salivary stimulation method, together with the other methods mentioned above, is that it can reduce the incidence of or eliminate adverse effects compared with chemical stimulation methods.…”