Current ideas to reduce or salvage radiation damage to salivary glands

Abstract

Radiation-induced hyposalivation is still a major problem after radiotherapy for head and neck cancer. Current and promising new thoughts to reduce or salvage radiation damage to salivary gland tissue are explored. The main cause underlying radiation-induced hyposalivation is a lack of functional saliva-producing acinar cells resulting from radiation-induced stem cell sterilization. Current methods to prevent that damage are radiation techniques to reduce radiation-injury to salivary gland tissue, surgical techniques to relocate salivary glands to a region receiving a lower cumulative radiation dose, and techniques to make salivary gland cells more resistant to radiation injury. These preventive techniques cannot be applied in all cases, also reduce tumor sensitivity, or do not result in a sufficient amelioration of the dryness-related complaints. Therefore, alternative methods on techniques to salvage salivary glands that are damaged by radiation are explored with promising results, such as stem cell therapies and gene transfer techniques to allow the radiation-injured salivary gland tissue to secrete water.

Keywords: IMRT; gene transfer; hyposalivation; radiotherapy; stem cells; xerostomia.