Master of Science Program in Nutrition and Dietetics, Institute of Nutrition, Mahidol University, Nakhon Pathom, Thailand.
Faculty of Dentistry, Srinakarinwirot University, Bangkok, Thailand.
Support Care Cancer. 2020 Jun;28(6):2817-2828. doi: 10.1007/s00520-019-05132-1. Epub 2019 Nov 15.
The aim of this study is to investigate the effect of an edible saliva substitute, oral moisturizing jelly (OMJ), and a topical saliva gel (GC) on dry mouth, swallowing ability, and nutritional status in post-radiotherapy head and neck cancer patients.
Sixty-two post-radiation head and neck cancer patients with xerostomia completed a blinded randomized controlled trial. They were advised to swallow OMJ (n = 31) or apply GC orally (n = 31) for 2 months. Outcome measures were assessed at baseline, 1, and 2 months, including subjective and objective dry mouth (Challcombe) scores, subjective swallowing problem scores (EAT-10), water swallowing time, clinical nutritional status (PG-SGA), body weight, and dietary intake.
After 1 and 2 months of interventions, subjective and objective dry mouth scores, subjective swallowing problem scores, swallowing times, and clinical nutritional status in both groups were significantly improved (p < 0.0001). Compared to GC, OMJ group had higher percent improvement in all outcome measures (p < 0.001) except swallowing time and clinical nutritional status. Interestingly, subjective dry mouth scores were significantly correlated with subjective swallowing problem scores (r = 0.5321, p < 0.0001).
Continuous uses of saliva substitutes (OMJ or GC) for at least a month improved signs and symptoms of dry mouth and enhanced swallowing ability. An edible saliva substitute was superior to a topical saliva gel for alleviating dry mouth and swallow problems. These lead to improved clinical nutritional status. Thus, palliation of dry mouth may be critical to support nutrition of post-radiotherapy head and neck cancer patients.
Clinicaltrials.gov NCT03035825.
本研究旨在探讨一种可食用唾液替代品(口腔保湿凝胶,OMJ)和一种局部唾液凝胶(GC)对放疗后头颈部癌症患者口干、吞咽能力和营养状况的影响。
62 例放疗后口干的头颈部癌症患者完成了一项双盲随机对照试验。他们被建议吞咽 OMJ(n = 31)或口服 GC(n = 31),持续 2 个月。在基线、1 个月和 2 个月时评估结局指标,包括主观和客观口干(Challcombe)评分、主观吞咽问题评分(EAT-10)、水吞咽时间、临床营养状况(PG-SGA)、体重和饮食摄入。
干预 1 个月和 2 个月后,两组的主观和客观口干评分、主观吞咽问题评分、吞咽时间和临床营养状况均显著改善(p < 0.0001)。与 GC 相比,OMJ 组在所有结局指标上的改善百分比均较高(p < 0.001),除吞咽时间和临床营养状况外。有趣的是,主观口干评分与主观吞咽问题评分呈显著相关(r = 0.5321,p < 0.0001)。
连续使用唾液替代品(OMJ 或 GC)至少 1 个月可改善口干的症状和吞咽能力。可食用唾液替代品在缓解口干和吞咽问题方面优于局部唾液凝胶。这导致临床营养状况得到改善。因此,缓解口干可能对头颈部癌症患者放疗后的营养支持至关重要。
Clinicaltrials.gov NCT03035825。