Current management of xerostomia in head and neck cancer patients

Cherie-Ann O Nathan; Ameya A Asarkar; Payam Entezami; June Corry; Primoz Strojan; Vincent Vander Poorten; Antti Makitie; Avraham Eisbruch; K T Robbins; Robert Smee; Maie St John; Carlos Chiesa-Estomba; Stuart C Winter; Jonathan J Beitler; Alfio Ferlito

doi:10.1016/j.amjoto.2023.103867

Current management of xerostomia in head and neck cancer patients

Am J Otolaryngol. 2023 Jul-Aug;44(4):103867. doi: 10.1016/j.amjoto.2023.103867. Epub 2023 Mar 28.

Authors

Affiliations

¹ Department of Otolaryngology/Head and Neck Surgery, LSU Health Sciences Center, Shreveport, LA, USA; Otolaryngology Section, Surgical Service, Overton Brooks VA Medical Center, Shreveport, LA, USA. Electronic address: Cherieann.nathan@lsuhs.edu.
² Department of Otolaryngology/Head and Neck Surgery, LSU Health Sciences Center, Shreveport, LA, USA.
³ Department of Otolaryngology/Head and Neck Surgery, LSU Health Sciences Center, Shreveport, LA, USA; Otolaryngology Section, Surgical Service, Overton Brooks VA Medical Center, Shreveport, LA, USA.
⁴ Department of Radiation Oncology, Genesiscare St Vincent's Hospital, Melbourne, Victoria, Australia.
⁵ Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
⁶ Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium.
⁷ Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
⁸ Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA.
⁹ Department of Otolaryngology/Head and Neck Surgery, Southern Illinois University, School of Medicine, Springfield, IL, USA.
¹⁰ Department of Radiation Oncology, The Prince of Wales Cancer Centre, Sydney, NSW, Australia.
¹¹ Department of Otolaryngology/Head and Neck Surgery, UCLA, CA, USA.
¹² Otorhinolaryngology - Head & Neck Department - Donostia University Hospital, Biodonostia Research Institute, Deusto University, Spain.
¹³ Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
¹⁴ Camden FD, Camden, ME, USA.
¹⁵ International Head and Neck Scientific Group, Padua, Italy.

PMID: 36996514
DOI: 10.1016/j.amjoto.2023.103867

Abstract

Radiotherapy (RT) continues to play a key role in the management of head and neck cancer (HNC). Xerostomia remains a principal detriment to the quality of life (QoL) for 80 % of surviving patients receiving head and neck radiation. Radiation-induced injury to the salivary glands is dose-dependent, and thus efforts have been focused on decreasing radiation to the salivary glands. Decreased saliva production reduces both short-term and long-term quality of life in head and neck survivors by impacting on taste and contributing to dysphagia. Several radioprotective agents to the salivary gland have been investigated. Although not widely practiced, surgical transfer of the submandibular gland prior to RT is the mainstay of surgical options in preventing xerostomia. This review focuses on the strategies to improve xerostomia following radiation therapy in head and neck cancers.

Keywords: Head and neck cancers; Radiation therapy; Salivary glands; Submandibular glands; Xerostomia.

Publication types

Review

MeSH terms

Head and Neck Neoplasms* / complications
Head and Neck Neoplasms* / radiotherapy
Humans
Quality of Life
Salivary Glands
Submandibular Gland
Xerostomia* / etiology
Xerostomia* / prevention & control