Department of Bioengineering, Biodesign Innovation Program, Stanford University, Stanford, CA 94305, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Jul;116(1):e37-51. doi: 10.1016/j.oooo.2013.02.017. Epub 2013 May 3.
Head and neck (H&N) radiation therapy (RT) can induce irreversible damage to the salivary glands thereby causing long-term xerostomia or dry mouth in 68%-85% of the patients. Not only does xerostomia significantly impair patients' quality-of-life (QOL) but it also has important medical sequelae, incurring high medical and dental costs. In this article, we review various measures to assess xerostomia and evaluate current and emerging solutions to address this condition in H&N cancer patients. These solutions typically seek to accomplish 1 of the 4 objectives: (1) to protect the salivary glands during RT, (2) to stimulate the remaining gland function, (3) to treat the symptoms of xerostomia, or (4) to regenerate the salivary glands. For each treatment, we assess its mechanisms of action, efficacy, safety, clinical utilization, and cost. We conclude that intensity-modulated radiation therapy is both the most widely used prevention approach and the most cost-effective existing solution and we highlight novel and promising techniques on the cost-effectiveness landscape.
头颈部（H&N）放射治疗（RT）可导致唾液腺不可逆转的损伤，从而使 68%-85%的患者发生长期口干或干燥症。口干不仅显著降低患者的生活质量（QOL），还会带来重要的医疗后果，导致高昂的医疗和牙科费用。本文综述了评估口干的各种方法，并评估了当前和新兴的治疗 H&N 癌症患者口干的解决方案。这些解决方案通常旨在实现以下 4 个目标中的 1 个：（1）在 RT 期间保护唾液腺，（2）刺激剩余腺体功能，（3）治疗口干症状，或（4）再生唾液腺。对于每种治疗方法，我们评估其作用机制、疗效、安全性、临床应用和成本。我们得出结论，调强放射治疗既是最广泛使用的预防方法，也是最具成本效益的现有解决方案，并强调了成本效益方面的新颖而有前途的技术。
