Prevention and treatment of the consequences of head and neck radiotherapy.
The location of the primary tumor or lymph node metastases dictates the inclusion of the oral cavity, salivary glands, and jaws in the radiation treatment portals for patients who have head and neck cancer. The clinical sequelae of the radiation treatment include mucositis, hyposalivation, loss of taste, osteoradionecrosis, radiation caries, and trismus. These sequelae may be dose-limiting and have a tremendous effect on the patient's quality of life. Most treatment protocols to prevent these sequelae are still based on clinical experience, but alternatives based on fundamental basic and clinical research are becoming more and more available. Many of these alternatives either need further study before they can be incorporated into the protocols commonly used to prevent and treat the radiation-related oral sequelae or await implementation of these protocols. In this review, the various possibilities for prevention and/or treatment of radiation-induced changes in healthy oral tissues and their consequences are discussed.
Vissink
A
A
Department of Oral and Maxillofacial Surgery, University Hospital, PO Box 30.001, 9700 RB Groningen, The Netherlands. A.Vissink@kchir.azg.nl
Burlage
F R
FR
Spijkervet
F K L
FK
Jansma
J
J
Coppes
R P
RP
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016371:Cranial Irradiation / Q000009:adverse effects*; D003731:Dental Caries / Q000209:etiology / Q000517:prevention & control; D004408:Dysgeusia / Q000209:etiology / Q000517:prevention & control; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D007571:Jaw Diseases / Q000209:etiology / Q000517:prevention & control*; D009059:Mouth Diseases / Q000209:etiology / Q000517:prevention & control*; D009061:Mouth Mucosa / Q000528:radiation effects; D018721:Muscarinic Agonists / Q000627:therapeutic use; D010025:Osteoradionecrosis / Q000209:etiology / Q000517:prevention & control*; D010862:Pilocarpine / Q000627:therapeutic use; D013280:Stomatitis / Q000209:etiology / Q000517:prevention & control*; D014313:Trismus / Q000209:etiology / Q000517:prevention & control; D014987:Xerostomia / Q000209:etiology / Q000517:prevention & control
D000900:Anti-Bacterial Agents; D018721:Muscarinic Agonists; D010862:Pilocarpine