Department of Oral Medicine, University of Copenhagen, Copenhagen N, Denmark.
Support Care Cancer. 2010 Aug;18(8):1061-79. doi: 10.1007/s00520-010-0837-6. Epub 2010 Mar 25.
This systematic review aimed to assess the literature for management strategies and economic impact of salivary gland hypofunction and xerostomia induced by cancer therapies and to determine the quality of evidence-based management recommendations.
The electronic databases of MEDLINE/PubMed and EMBASE were searched for articles published in English since the 1989 NIH Development Consensus Conference on the Oral Complications of Cancer Therapies until 2008 inclusive. For each article, two independent reviewers extracted information regarding study design, study population, interventions, outcome measures, results, and conclusions.
Seventy-two interventional studies met the inclusion criteria. In addition, 49 intensity-modulated radiation therapy (IMRT) studies were included as a management strategy aiming for less salivary gland damage. Management guideline recommendations were drawn up for IMRT, amifostine, muscarinic agonist stimulation, oral mucosal lubricants, acupuncture, and submandibular gland transfer.
There is evidence that salivary gland hypofunction and xerostomia induced by cancer therapies can be prevented or symptoms be minimized to some degree, depending on the type of cancer treatment. Management guideline recommendations are provided for IMRT, amifostine, muscarinic agonist stimulation, oral mucosal lubricants, acupuncture, and submandibular gland transfer. Fields of sparse literature identified included effects of gustatory and masticatory stimulation, specific oral mucosal lubricant formulas, submandibular gland transfer, acupuncture, hyperbaric oxygen treatment, management strategies in pediatric cancer populations, and the economic consequences of salivary gland hypofunction and xerostomia.
本系统评价旨在评估癌症治疗引起的唾液腺功能低下和口干的治疗策略和经济影响的文献，并确定基于循证管理建议的质量。
检索 MEDLINE/PubMed 和 EMBASE 电子数据库，以获取自 1989 年 NIH 癌症治疗口腔并发症发展共识会议以来至 2008 年期间发表的英文文献。对于每篇文章，两名独立的评审员提取有关研究设计、研究人群、干预措施、结果测量、结果和结论的信息。
符合纳入标准的干预性研究共 72 项。此外，还纳入了 49 项强度调节放射治疗（IMRT）研究，作为旨在减少唾液腺损伤的治疗策略。制定了关于 IMRT、氨磷汀、拟副交感神经刺激、口腔黏膜润滑剂、针灸和颌下腺转移的管理指南建议。
有证据表明，癌症治疗引起的唾液腺功能低下和口干可以预防或在一定程度上减轻症状，具体取决于癌症治疗的类型。为 IMRT、氨磷汀、拟副交感神经刺激、口腔黏膜润滑剂、针灸和颌下腺转移提供了管理指南建议。文献稀少的领域包括味觉和咀嚼刺激的影响、特定的口腔黏膜润滑剂配方、颌下腺转移、针灸、高压氧治疗、儿科癌症人群的管理策略以及唾液腺功能低下和口干的经济后果。
