title: Changes in salivary flow rates in head and neck cancer after chemoradiotherapy.
abstract: BACKGROUND
  Changes in salivary flow rate were studied in head and neck (H and N) cancer patients who, after receiving moderately accelerated radiotherapy (RT) and concurrent chemotherapy (CT), were free of disease at 1 year.
  
  
  METHODS
  Between July 2003 and July 2005, saliva estimation was performed for 36 patients of locally advanced (AJCC stages III and IV) squamous cell carcinoma of the H and N. RT, moderately accelerated (70 Gy/35 fx/6 weeks) along with concurrent weekly cisplatin at 35 mg/m 2 (capped at 50 mg) with standard hydration and anti-emetic cover, was planned using conventional planning on telecobalt or 6 MV photons. The saliva flow rate was estimated for 5 min at rest (unstimulated) and after using lemon drops (stimulated) for the next 5 min at baseline (pre-treatment), 3, 6 and 12 months following treatment.
  
  
  RESULTS
  The median follow-up of this study was 29 months. Compared with baseline, by 3 months, a significant reduction in unstimulated (0.35 ml/min and 0.10 ml/min) and stimulated (0.97 ml/min and 0.28 ml/min) salivary flow rate was observed, respectively. This continued to decrease further till 6 months (0.06 ml/min and 0.17 ml/min) and, by 12 months, a minimal and non-significant recovery was observed in both unstimulated (0.08 ml/min) and stimulated salivary flow rates (0.22 ml/min), respectively.
  
  
  CONCLUSIONS
  Salivary flow rates fall to a fourth of the baseline value with the above CT + RT protocol, with minimal recovery at 12 months following completion of treatment.
authors.affiliation: Department of Radiotherapy, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow - 226 014, India. punital@yahoo.com
authors.forename: Punita
authors.initials: P
authors.lastname: Lal
authors.forename: Ranjeet
authors.initials: R
authors.lastname: Bajpai
authors.forename: Rohini
authors.initials: R
authors.lastname: Khurana
authors.forename: K J Maria
authors.initials: KJ
authors.lastname: Das
authors.forename: Prabhat
authors.initials: P
authors.lastname: Kumar
authors.forename: Anu
authors.initials: A
authors.lastname: Tiwari
authors.forename: Neha
authors.initials: N
authors.lastname: Gupta
authors.forename: Shaleen
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000503:physiopathology* / Q000532:radiotherapy; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000503:physiopathology* / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012463:Saliva / Q000378:metabolism*