title: Salivary gland sparing in the treatment of head and neck cancer.
abstract: Radiotherapy is an important component of the multimodality treatment of head and neck cancer. Although an effective treatment for many patients, it can have significant long-term sequelae. In particular, xerostomia - or dry mouth - caused by salivary gland injury is a serious problem suffered by most patients and leads to problems with oral comfort, dental health, speech and swallowing. This article explores the mechanisms behind radiation injury to the major salivary glands, as well as different strategies to minimize and alleviate xerostomia. This includes technical approaches to minimize radiation dose to salivary tissue, such as intensity-modulated radiotherapy and surgical transfer of salivary glands, as well as pharmacologic approaches to stimulate or protect the salivary tissue. The scientific literature will be critically examined to see what works and what strategies have been less effective in attempting to minimize xerostomia in head and neck cancer patients.
authors.affiliation: Department of Oncology, University of Alberta, 11560 University Ave NW, Edmonton, AB, T6G 1Z2, Canada. rufus.scrimger@albertahealthservices.ca
authors.forename: Rufus
authors.initials: R
authors.lastname: Scrimger
mesh_terms: D000818:Animals; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D011832:Radiation Injuries / Q000209:etiology* / Q000517:prevention & control*; D011878:Radiotherapy / Q000009:adverse effects; D012469:Salivary Glands / Q000528:radiation effects*; D014987:Xerostomia / Q000209:etiology* / Q000517:prevention & control*