title: Evaluation of oral prophylaxis during and after intensity-modulated radiotherapy due to head and neck cancer--a retrospective study.
abstract: OBJECTIVE
  The aim of this study was to retrospectively analyze the influence of a prophylaxis protocol of head and neck tumor (HNT) patients during and after intensity-modulated radiotherapy (IMRT).
  
  
  METHODS
  In this 5-year retrospective study (2009-2013), 70 (m 55, f 15; age range 28-8 years; median 58.7 years) out of 248 HNT patients of the Clinic of Cranio-Maxillofacial and Oral Surgery at the University of Zurich, Switzerland, fulfilled the inclusion criteria. Parameters of investigation were the salivary flow rates, possible dental foci and the dental status, oral side effects of radiotherapy, the prophylaxis protocol, and patient's compliance to this protocol. The following time points before during and after IMRT (6 weeks) were analyzed: prior to IMRT, 2-4 weeks, 6 weeks and 3, 6, and 12 months after the onset of radiotherapy.
  
  
  RESULTS
  Unstimulated salivary flow rate, pH value of unstimulated salivary, and stimulated salivary flow rate showed a significant reduction over time (p < 0.001). One year after IMRT, both unstimulated and stimulated salivary flow showed a statistically significant lower salivary flow. The number of caries-affected sites per patient was significantly higher for patients with low compliance to the prophylaxis protocol (mean: low compliance 1.36, high compliance 0.26). Almost 75% of the evaluated patients suffered immediate gustatory change, and 47.1% showed signs of radiostomatitis through IMRT.
  
  
  CONCLUSIONS
  High compliance to the prophylaxis protocol during and after radiotherapy is a key factor for the reduction of radiation side effects on dental hard tissue.
  
  
  CONCLUSIONS
  High compliance to a monitored prophylaxis program is crucial for patients after head and neck surgery.
authors.affiliation: Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Zurich, Zurich, Switzerland. dominique.bichsel@zzm.uzh.ch.
authors.forename: D
authors.initials: D
authors.lastname: Bichsel
authors.affiliation: Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Lanfranchi
authors.affiliation: Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: T
authors.initials: T
authors.lastname: Attin
authors.affiliation: Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: K W
authors.initials: KW
authors.lastname: Grätz
authors.affiliation: Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Stadlinger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D013557:Switzerland; D014987:Xerostomia / Q000209:etiology
keywords: Compliance; Head and neck tumor; Prophylaxis; Radiotherapy; Salivary flow parameters