Submandibular Gland Transfer for the Prevention of Postradiation Xerostomia in Patients with Head and Neck Cancer: A Systematic Review and Meta-Analysis

Abstract

Background: Submandibular gland transfer has been widely used to prevent postradiation xerostomia in head-and-neck cancers. However, there are still some controversies. Methods: Six databases were searched, data extraction was performed and the risk of bias was assessed by 2 reviewers independently. The meta-analysis was performed using Review Manager, version 5.2. Results: A total of 7 trials (12 articles) and 369 participants were included. Conclusions: The present clinical evidence suggests that submandibular gland transfer might be highly effective to prevent postradiation xerostomia in head-and-neck cancers without serious adverse events. However, more randomized controlled trials are still needed to confirm this conclusion.

Root resorption during orthodontic treatment with self-ligating or conventional brackets: a systematic review and meta-analysis

“…The risk of bias assessment form recommended by Saltaji et al [14] and Wu et al [15] was used to evaluate the risk of bias of included studies. This assessment system evaluated the risk of bias on the basis of four broad perspectives: study design (8 items), study measurements (3 items), statistical analysis (3 items) and baseline information (1 item), with a maximum score of 19. the item was scored as 1 point (√) when the trial reported the domain properly, as 0.5 point (≠) when the trial partially fulfilled the criteria and as 0 point (×) when the trial did not fulfill the methodological criteria (Table 1).…”

“…This assessment system evaluated the risk of bias on the basis of four broad perspectives: study design (8 items), study measurements (3 items), statistical analysis (3 items) and baseline information (1 item), with a maximum score of 19. the item was scored as 1 point (√) when the trial reported the domain properly, as 0.5 point (≠) when the trial partially fulfilled the criteria and as 0 point (×) when the trial did not fulfill the methodological criteria (Table 1). The study was assessed as ‘low risk of bias’ when the score was higher than 15, ‘moderate risk of bias’ when the score was between 10 and 15, and ‘high risk of bias’ when the score was less than 10 points [14, 15]. …”

Functional outcomes of the modified submandibular gland transfer procedure

“…Furthermore, patients undergoing the SGT showed better swallowing outcomes without any surgical complications associated with the procedure . These findings were further supported by multiple systematic reviews and meta‐analyses that concluded SGT is highly effective in preventing the incidence of xerostomia in patients receiving RT …”

“…11,12,14,15 These findings were further supported by multiple systematic reviews and meta-analyses that concluded SGT is highly effective in preventing the incidence of xerostomia in patients receiving RT. 16,17 The classical SGT is, however, only indicated in patients with primary cancers in which the submental area is spared by the radiation field during treatment (larynx, oropharynx, hypopharynx, skin, or unknown primaries). Unfortunately, its use is contraindicated in oral cavity primaries because the submental area cannot be effectively or safely shielded from radiation.…”

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“…In patients treated through chemotherapy and radiotherapy, amifostine prevented chronic xerostomia, but it was not effective on acute xerostomia [51]. The side effects that patients using amifostine can present during oncologic treatment are arterial hypotension, nausea, vomits, asthenia, fever, mucositis, tachycardia, bronchitis, allergic reaction and rash [33,52,53]. The higher the applied dose, the more severe the side effects related to amifostine.…”