Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: Xerostomia and trismus (Part 2). Literature review and consensus statement

Michela Buglione; Roberta Cavagnini; Federico Di Rosario; Marta Maddalo; Lucia Vassalli; Salvatore Grisanti; Stefano Salgarello; Ester Orlandi; Paolo Bossi; Alessandra Majorana; Giorgio Gastaldi; Alfredo Berruti; Fabio Trippa; Pietro Nicolai; Andrei Barasch; Elvio G Russi; Judith Raber-Durlacher; Barbara Murphy; Stefano M Magrini

doi:10.1016/j.critrevonc.2016.03.012

Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: Xerostomia and trismus (Part 2). Literature review and consensus statement

Crit Rev Oncol Hematol. 2016 Jun:102:47-54. doi: 10.1016/j.critrevonc.2016.03.012. Epub 2016 Mar 11.

Authors

Michela Buglione¹, Roberta Cavagnini², Federico Di Rosario³, Marta Maddalo⁴, Lucia Vassalli⁵, Salvatore Grisanti⁶, Stefano Salgarello⁷, Ester Orlandi⁸, Paolo Bossi⁹, Alessandra Majorana¹⁰, Giorgio Gastaldi¹¹, Alfredo Berruti¹², Fabio Trippa¹³, Pietro Nicolai¹⁴, Andrei Barasch¹⁵, Elvio G Russi¹⁶, Judith Raber-Durlacher¹⁷, Barbara Murphy¹⁸, Stefano M Magrini¹⁹

Affiliations

¹ Radiation Oncology Department, Spedali Civili Hospital, Brescia University, Italy. Electronic address: michela.buglione@unibs.it.
² Radiation Oncology Department, Spedali Civili Hospital, Brescia University, Italy. Electronic address: rcnero@gmail.com.
³ Department of Oral Diagnosis, Oral Medicine & Oral Pathology, Spedali Civili Hospital, Brescia University, Italy. Electronic address: fedric81@gmail.com.
⁴ Radiation Oncology Department, Spedali Civili Hospital, Brescia University, Italy. Electronic address: marta.maddalo@gmail.com.
⁵ Medical Oncology Department, Spedali Civili Hospital, Brescia University, Italy. Electronic address: lucia.vassalli@libero.it.
⁶ Medical Oncology Department, Spedali Civili Hospital, Brescia University, Italy. Electronic address: salvatore.grisanti@tin.it.
⁷ Department of Oral Diagnosis, Oral Medicine & Oral Pathology, Spedali Civili Hospital, Brescia University, Italy. Electronic address: stefano.salgarello@unibs.it.
⁸ Radio-Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. Electronic address: Ester.Orlandi@istitutotumori.mi.it.
⁹ Head and Neck Medical Oncology Unit, Fondazione, IRCCS Istituto Nazionale Tumori, Milan, Italy. Electronic address: paolo.bossi@istitutotumori.mi.it.
¹⁰ Department of Oral Diagnosis, Oral Medicine & Oral Pathology, Spedali Civili Hospital, Brescia University, Italy. Electronic address: alessandra.majorana@unibs.it.
¹¹ Department of Oral Diagnosis, Oral Medicine & Oral Pathology, Spedali Civili Hospital, Brescia University, Italy. Electronic address: giorgio.gastaldi@unibs.it.
¹² Medical Oncology Department, Spedali Civili Hospital, Brescia University, Italy. Electronic address: alfredo.berruti@gmail.com.
¹³ Radiation Oncology Department, Azienda Ospedaliera 'S. Maria', TERNI, Italy. Electronic address: f.trippa@aospterni.it.
¹⁴ ENT Clinic and Head and Neck Department Spedali Civili Hospital, Brescia University, Italy. Electronic address: piero.nicolai@unibs.it.
¹⁵ Department of General Dental Sciences, University of Alabama at Birmingham, USA. Electronic address: barasaff@cs.com.
¹⁶ Radiation Oncology Department AO. S. Croce e Carle, Cuneo, Italy. Electronic address: elviorussi@gmail.com.
¹⁷ Department of Oral and Maxillofacial Surgery, Academic Medical Center Amsterdam, University of Amsterdam, Amsterdam, The Netherlands; Department of Medical Dental Interaction, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands. Electronic address: j.e.raberdurlacher@amc.uva.nl.
¹⁸ Division of Hematology/Oncology, Department of Medicine, Vanderbilt University, Nashville, TN, USA. Electronic address: barbara.murphy@vanderbilt.edu.
¹⁹ Radiation Oncology Department, Spedali Civili Hospital, Brescia University, Italy. Electronic address: stefano.magrini@unibs.it.

PMID: 27061883
DOI: 10.1016/j.critrevonc.2016.03.012

Abstract

Radiotherapy alone or in combination with chemotherapy and/or surgery is a well-known radical treatment for head and neck cancer patients. Nevertheless acute side effects (such as moist desquamation, skin erythema, loss of taste, mucositis etc.) and in particular late toxicities (osteoradionecrosis, xerostomia, trismus, radiation caries etc.) are often debilitating and underestimated. A multidisciplinary group of head and neck cancer specialists from Italy met in Milan with the aim of reaching a consensus on a clinical definition and management of these toxicities. The Delphi Appropriateness method was used for this consensus and external experts evaluated the conclusions. The paper contains 20 clusters of statements about the clinical definition and management of stomatological issues that reached consensus, and offers a review of the literature about these topics. The review was split into two parts: the first part dealt with dental pathologies and osteo-radionecrosis (10 clusters of statements), whereas this second part deals with trismus and xerostomia (10 clusters of statements).

Keywords: Chemotherapy; Head and neck cancer; Radio-induced trismus; Radio-induced xerostomia; Radiotherapy; Trismus; Xerostomia.

Publication types

Review

MeSH terms

Antineoplastic Agents / adverse effects*
Chemoradiotherapy / adverse effects*
Consensus
Head and Neck Neoplasms / therapy*
Humans
Radiation Injuries / therapy*
Trismus / etiology
Trismus / therapy*
Xerostomia / therapy*

Substances

Antineoplastic Agents