title: Clinical observation of submandibular gland transfer for the prevention of xerostomia after radiotherapy for nasopharyngeal carcinoma: a prospective randomized controlled study of 32 cases.
abstract: BACKGROUND
  The aim of this study was to evaluate the clinical efficacy of submandibular gland transfer for the prevention of xerostomia after radiotherapy for nasopharyngeal carcinoma.
  
  
  METHODS
  Using the randomized controlled clinical research method, 65 patients with nasopharyngeal carcinoma were randomly divided into an experimental group consisting of 32 patients and a control group consisting of 33 patients. The submandibular glands were averted to the submental region in 32 patients with nasopharyngeal carcinoma before they received conventional radiotherapy; a lead block was used to shield the submental region during therapy. Prior to radiotherapy, the function of the submandibular glands was assessed using imaging. Submandibular gland function was measured using 99mTc radionuclide scanning at 60 months after radiotherapy. The data in the questionnaire regarding the degree of xerostomia were investigated and saliva secretion was measured at 3, 6, 12, and 60 months after radiotherapy. In addition, the 5-year survival rate was calculated.
  
  
  RESULTS
  After follow-up for 3, 6, and 12 months, the incidence of moderate to severe xerostomia was significantly lower in the experimental group than in the control group. The average amount of saliva produced by the experimental and control groups was 1.60 g and 0.68 g, respectively (P<0.001). After follow-up for 60 months, the uptake and secretion functions of the submandibular glands in the experimental group were found to be significantly higher than in the control group (P<0.001 and P<0.001, respectively). The incidence of moderate or severe xerostomia was significantly lower than in the control group (15.4% and 76.9%, respectively; P<0.001). The 5-year survival rates of the experimental group and the control group were 81.3% and 78.8%, respectively, and there was no significant difference between the two groups (P=0.806).
  
  
  CONCLUSIONS
  After a 5 year follow-up period involving 32 patients who had their submandibular glands transferred for the prevention of xerostomia after radiotherapy for nasopharyngeal carcinoma, we found that clinical efficacy was good. This approach could improve the quality of life of nasopharyngeal carcinoma patients after radiotherapy and would not affect long-term treatment efficacy.
authors.forename: Xiangmin
authors.initials: X
authors.lastname: Zhang
authors.forename: Folin
authors.initials: F
authors.lastname: Liu
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Lan
authors.forename: Lijiang
authors.initials: L
authors.lastname: Yu
authors.forename: Wei
authors.initials: W
authors.lastname: Wu
authors.forename: Xiuhong
authors.initials: X
authors.lastname: Wu
authors.forename: Fufu
authors.initials: F
authors.lastname: Xiao
authors.affiliation: Ganzhou Institute of Cancer Research, No, 19, HuaYuan Qian Road, Ganzhou 341000, Jiangxi Province, People's Republic of China. Lsj1362@126.com.
authors.forename: Shaojin
authors.initials: S
authors.lastname: Li
mesh_terms: D000328:Adult; D002277:Carcinoma; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000532:radiotherapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D058958:Organs at Risk / Q000000981:diagnostic imaging / Q000601:surgery; D011832:Radiation Injuries / Q000517:prevention & control*; D011877:Radionuclide Imaging; D000077195:Squamous Cell Carcinoma of Head and Neck; D013363:Submandibular Gland / Q000000981:diagnostic imaging / Q000528:radiation effects / Q000637:transplantation*; D016896:Treatment Outcome; D014987:Xerostomia / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult