Jha N, Seikaly H, McGaw T, Coulter L
Department of Radiation Oncology, University of Alberta, Edmonton, Canada.
Int J Radiat Oncol Biol Phys. 2000 Jan 1;46(1):7-11. doi: 10.1016/s0360-3016(99)00460-5.
Xerostomia is a significant morbidity of radiation therapy in the management of head and neck cancers. We hypothesized that the surgical transfer of one submandibular salivary gland to submental space, outside the proposed radiation field, prior to starting radiation treatment, would prevent xerostomia.
We are conducting a prospective clinical trial where the submandibular gland is transferred as part of the surgical intervention. The patients are followed clinically, with salivary flow studies and University of Washington quality of life questionnaire.
We report early results of 16 patients who have undergone this procedure. Seven patients have finished and 2 patients are currently undergoing radiation treatment. In 2 patients, no postoperative radiation treatment was indicated. Two patients are waiting to start radiation treatment and 2 patients refused treatment after surgery. The surgical transfer was abandoned in 1 patient. All of the transferred salivary glands were positioned outside the proposed radiation fields and were functional. The patients did not complain of any xerostomia and developed only minimal oral mucositis. There were no surgical complications.
Surgical transfer of a submandibular salivary gland to the submental space (outside the radiation field) preserves its function and prevents the development of radiation-induced xerostomia.
口干是头颈部癌症放疗过程中的一种严重并发症。我们推测，在开始放疗前，将一侧下颌下唾液腺手术转移至颏下间隙（位于计划放疗野之外）可预防口干。
我们正在开展一项前瞻性临床试验，将下颌下腺转移作为手术干预的一部分。对患者进行临床随访，并进行唾液流量研究以及使用华盛顿大学生活质量问卷。
我们报告了16例接受该手术患者的早期结果。7例患者已完成放疗，2例患者目前正在接受放疗。2例患者术后未进行放疗。2例患者等待开始放疗，2例患者术后拒绝治疗。1例患者放弃了手术转移。所有转移的唾液腺均位于计划放疗野之外且功能良好。患者未诉有任何口干，仅出现轻微的口腔黏膜炎。无手术并发症。
将下颌下唾液腺手术转移至颏下间隙（放疗野之外）可保留其功能并预防放射性口干的发生。
