Evaluation, prevention and management of radiotherapy-induced xerostomia in head and neck cancer patients.
OBJECTIVE
As part of the multidisciplinary approach to head and neck cancer patients, radiation therapy plays an essential role, improving locoregional control. Radiation therapy-induced xerostomia is a late side-effect that increases the risk for developing dental caries and compromises oral mucosal integrity, resulting in oral pain, loss of taste, difficulties with swallowing and chewing, sleep disorders and worse quality of life. This review focuses on evaluation, prevention and management of radiation therapy-induced xerostomia.


RESULTS
In terms of xerostomia prevention, some clinical trials evaluating amifostine and intensity-modulated radiation therapy have shown positive results. Pilocarpine is a useful agent as a treatment of radiation-induced xerostomia in head and neck cancer patients.


CONCLUSIONS
Despite some advances in radiation therapy-induced xerostomia prevention, its treatment is an area in which advances are urgently needed.
de Castro
Gilberto
G
Clinical Oncology Service, InRad, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. gilbertocastro@lim24.fm.usp.br
Federico
Miriam Hatsue Honda
MH
D004999:Amifostine / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D002986:Clinical Trials as Topic; D003594:Cytoplasmic Granules / Q000201:enzymology / Q000378:metabolism; D016166:Free Radical Scavengers / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D015227:Lipid Peroxidation / Q000528:radiation effects; D010277:Parasympathomimetics / Q000627:therapeutic use; D010862:Pilocarpine / Q000627:therapeutic use; D011832:Radiation Injuries / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D011837:Radiation-Protective Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D011878:Radiotherapy / Q000009:adverse effects; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects; D012469:Salivary Glands / Q000378:metabolism / Q000528:radiation effects*; D014987:Xerostomia / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control
D016166:Free Radical Scavengers; D010277:Parasympathomimetics; D011837:Radiation-Protective Agents; D010862:Pilocarpine; D004999:Amifostine