title: Salivary gland transfer to prevent radiation-induced xerostomia: a systematic review and meta-analysis.
abstract: Salivary gland transfer (SGT) has the potential to prevent radiation-induced xerostomia. We attempt to analyze the efficacy of SGT in prevention of xerostomia and maintenance of salivary flow rates after radiation treatment (XRT). Systematic review and meta-analysis. Primary endpoint was efficacy of SGT in prevention of radiation-induced xerostomia. Secondary endpoint was change from baseline of unstimulated and stimulated salivary flow rates after XRT. Seven articles, accruing data from 12 institutions, met inclusion criteria. In a total of 177 patients at mean follow-up of 22.7months, SGT prevented radiation-induced xerostomia in 82.7% (95% CI, 76.6-87.7%) of patients. Twelve months after XRT, unstimulated and stimulated salivary flow rates rose to 88% and 76% of baseline values, respectively. In comparison to control subjects twelve months after XRT, SGT subjects' unstimulated (75% vs. 11%) and stimulated (86% vs. 8%) salivary flow rates were drastically higher in SGT patients. Salivary gland transfer appears to be highly effective in preventing the incidence of xerostomia in patients receiving definitive head and neck radiation therapy.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, United States.
authors.forename: Amit J
authors.initials: AJ
authors.lastname: Sood
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, United States.
authors.forename: Nyssa F
authors.initials: NF
authors.lastname: Fox
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, United States.
authors.forename: Brendan P
authors.initials: BP
authors.lastname: O'Connell
authors.affiliation: College of Dental Medicine, Medical University of South Carolina, United States.
authors.forename: Tiffany L
authors.initials: TL
authors.lastname: Lovelace
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, United States.
authors.forename: Shaun A
authors.initials: SA
authors.lastname: Nguyen
authors.affiliation: Department of Radiation Oncology, Medical University of South Carolina, United States.
authors.forename: Anand K
authors.initials: AK
authors.lastname: Sharma
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, United States.
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Hornig
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, United States. Electronic address: headneck@musc.edu.
authors.forename: Terry A
authors.initials: TA
authors.lastname: Day
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D017060:Patient Satisfaction; D011832:Radiation Injuries / Q000517:prevention & control*; D012469:Salivary Glands / Q000601:surgery*; D016896:Treatment Outcome; D014987:Xerostomia / Q000517:prevention & control*
keywords: Head and neck cancer; Radiation-induced xerostomia; Radiotherapy; Salivary gland transfer; Xerostomia