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Long-term outcomes of interventions for radiation-induced xerostomia:A review

查看全文 作　　者：Sung Jun [1,2]Ma;Charlotte I [1,2]Rivers;Lucas M [1,2]Serra;Anurag K [1,2]Singh 高影响力作者 机构地区：[1]University at Buffalo, The State University of New York, Jacobs School of Medicine and Biomedical Sciences;[2]Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center高影响力机构 出　　处：《World Journal of Clinical Oncology》索引2019年第10卷第1期,共13页高影响力期刊 摘　　要：Xerostomia, or dry mouth, is a significant problem affecting quality of life in patients treated with radiation therapy for head and neck cancer. Strategies for reduction of xerostomia burden vary widely, with options including: sialagogue medications, saliva substitutes, acupuncture, vitamins, hyperbaric oxygen,submandibular gland transfer, and acupuncture or associated treatments. In this review, we sought to evaluate long-term outcomes of patients treated with various interventions for radiation-induced xerostomia. A literature search was performed using the terms 'xerostomia' and 'radiation' or 'radiotherapy'; all prospective clinical trials were evaluated, and only studies that reported 1 year follow up were included. The search results yielded 2193 studies, 1977 of which were in English. Of those, 304 were clinical trials or clinical studies. After abstract review, 23 trials were included in the review evaluating the following treatment modalities: pilocarpine(three); cevimeline(one); amifostine(eleven);submandibular gland transfer(five); acupuncture like transcutaneous electrical nerve stimulation(ALTENS)(one); hyperbaric oxygen(one); and acupuncture(one). Pilocarpine, cevimeline, and amifostine have been shown in some studies to improve xerostomia outcomes, at the cost of toxicity. ALTENS has similar efficacy with fewer side effects. Submandibular gland transfer is effective but requires an elective surgery, and thus may not always be appropriate or practical.The use of intensity-modulated radiation therapy, in addition to dose deescalation in select patients, may result in fewer patients with late xerostomia,reducing the need for additional interventions. 关 键 词：XEROSTOMIA RADIATION therapy RADIOTHERAPY Head and NECK cancer Quality of LIFE
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