title: Cost-effectiveness landscape analysis of treatments addressing xerostomia in patients receiving head and neck radiation therapy.
abstract: Head and neck (H&N) radiation therapy (RT) can induce irreversible damage to the salivary glands thereby causing long-term xerostomia or dry mouth in 68%-85% of the patients. Not only does xerostomia significantly impair patients' quality-of-life (QOL) but it also has important medical sequelae, incurring high medical and dental costs. In this article, we review various measures to assess xerostomia and evaluate current and emerging solutions to address this condition in H&N cancer patients. These solutions typically seek to accomplish 1 of the 4 objectives: (1) to protect the salivary glands during RT, (2) to stimulate the remaining gland function, (3) to treat the symptoms of xerostomia, or (4) to regenerate the salivary glands. For each treatment, we assess its mechanisms of action, efficacy, safety, clinical utilization, and cost. We conclude that intensity-modulated radiation therapy is both the most widely used prevention approach and the most cost-effective existing solution and we highlight novel and promising techniques on the cost-effectiveness landscape.
authors: Department of Bioengineering, Biodesign Innovation Program, Stanford University, Stanford, CA 94305, USA. laura.sasportas@centraliens.net
authors: Laura S
authors: LS
authors: Sasportas
authors: Drew N
authors: DN
authors: Hosford
authors: Maria A
authors: MA
authors: Sodini
authors: Dale J
authors: DJ
authors: Waters
authors: Elizabeth A
authors: EA
authors: Zambricki
authors: Joëlle K
authors: JK
authors: Barral
authors: Edward E
authors: EE
authors: Graves
authors: Todd J
authors: TJ
authors: Brinton
authors: Paul G
authors: PG
authors: Yock
authors: Quynh-Thu
authors: QT
authors: Le
authors: Davud
authors: D
authors: Sirjani
mesh_terms: D003362:Cost-Benefit Analysis; D006258:Head and Neck Neoplasms / Q000150:complications / Q000532:radiotherapy*; D006801:Humans; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects; D012466:Salivary Gland Diseases / Q000191:economics / Q000209:etiology* / Q000628:therapy; D012469:Salivary Glands / Q000473:pathology*; D014987:Xerostomia / Q000191:economics* / Q000209:etiology / Q000628:therapy
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