[Primary effect of submandibular salivary gland transfer in preventing radiation-induced xerostomia of nasopharyngeal carcinoma].
OBJECTIVE
Xerostomia, an ubiquitous sequelae in nasopharyngeal carcinoma (NPC) patients after radiotherapy, seriously affects life quality of the patients. This study was to investigate clinical value of submandibular salivary gland transfer in preventing radiation-induced xerostomia of NPC patients.


METHODS
A total of 70 eligible patients with NPC were recruited, and divided into test group (36 patients) and control group (34 patients). In test group, the submandibular glands were transferred to the submental spaces before conventional radiotherapy. The submental spaces were shielded during radiotherapy. Oral cavity mucous membrane reaction during radiotherapy, submandibular gland function and salivary fluid before and after radiotherapy, and questionnaire of xerostomia 3 months after radiotherapy were compared between test group and control group.


RESULTS
Acute oral cavity mucous membrane reaction was severer in control group than in test group; the incidence of stage III reaction was significantly higher in control group than in test group ( 8/34 vs. 3/36, P = 0.007). Three months after radiotherapy, trapping and excretion functions of the transferred submandibular glands were significantly better than those of the untransferred submandibular glands in test group (P = 0.001 and P = 0.000); trapping and excretion functions of the submandibular glands were significantly better in test group than in control group (P = 0.004 and P = 0.000). The mean weight of salivary fluid after radiotherapy was heavier in test group than in control group (1.41 g vs. 0.71 g). Incidence of moderate to severe degree of xerostomia was significantly higher in test group than in control group (76.5% vs. 13.9%, P = 0.000).


CONCLUSIONS
Submandibular gland transfer may be used to prevent radiation-induced xerostomia of NPC patients, and may improve life quality of the patients.
Liu
Xue-Kui
XK
Department of Head and Neck Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, P.R.China. liuxuekui@sohu.com
Zeng
Zong-Yuan
ZY
Hong
Ming-Huang
MH
Cui
Nian-Ji
NJ
Su
Yong
Y
Mai
Hai-Qiang
HQ
Chen
Fu-Jin
FJ
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D009367:Neoplasm Staging; D010315:Particle Accelerators; D011446:Prospective Studies; D011788:Quality of Life; D011882:Radiotherapy, High-Energy / Q000009:adverse effects; D012463:Saliva / Q000378:metabolism; D013363:Submandibular Gland / Q000378:metabolism / Q000601:surgery*; D011795:Surveys and Questionnaires; D014987:Xerostomia / Q000209:etiology / Q000517:prevention & control*