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Review
. 2015 Feb 4:11:171-88.
doi: 10.2147/TCRM.S70652. eCollection 2015.

Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage

Roberto Pinna  1 , Guglielmo Campus  2 , Enzo Cumbo  3 , Ida Mura  1 , Egle Milia  2
Affiliations
Review

Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage

Roberto Pinna et al. Ther Clin Risk Manag. .

Abstract

Background: The irradiation of head and neck cancer (HNC) often causes damage to the salivary glands. The resulting salivary gland hypofunction and xerostomia seriously reduce the patient's quality of life.

Purpose: To analyze the literature of actual management strategies for radiation-induced hypofunction and xerostomia in HNC patients.

Methods: MEDLINE/PubMed and the Cochrane Library databases were electronically evaluated for articles published from January 1, 1970, to June 30, 2013. Two reviewers independently screened and included papers according to the predefined selection criteria.

Results: Sixty-one articles met the inclusion criteria. The systematic review of the literature suggests that the most suitable methods for managing the clinical and pathophysiological consequences of HNC radiotherapy might be the pharmacological approach, for example, through the use of cholinergic agonists when residual secretory capacity is still present, and the use of salivary substitutes. In addition, a modified diet and the patient's motivation to enhance oral hygiene can lead to a significant improvement.

Conclusion: Radiation-induced xerostomia could be considered a multifactorial disease. It could depend on the type of cancer treatment and the cumulative radiation dose to the gland tissue. A preventive approach and the correct treatment of the particular radiotherapeutic patient can help to improve the condition of xerostomia.

Keywords: management strategies; radiation-induced xerostomia; salivary gland hypofunction.

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Figures

Figure 1
Figure 1
Search flowchart.
Figure 2
Figure 2
Viscous appearance of the saliva in a radiotherapeutic patient.
Figure 3
Figure 3
Dry and sticky appearance of oral mucosa in a radiotherapeutic patient.
Figure 4
Figure 4
Cheilitis and cracked lips, and teeth cervical caries in a radiotherapeutic patient.
See this image and copyright information in PMC

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