Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.
J Clin Invest. 2024 Sep 3;134(17):e182661. doi: 10.1172/JCI182661.
Salivary gland dysfunction is a common side effect of cancer treatments. Salivary function plays key roles in critical daily activities. Consequently, changes in salivary function can profoundly impair quality of life for cancer patients. We discuss salivary gland anatomy and physiology to understand how anticancer therapies such as chemotherapy, bone marrow transplantation, immunotherapy, and radiation therapy impair salivary function. We discuss approaches to quantify xerostomia in the clinic, including the advantages and limitations of validated quality-of-life instruments and approaches to directly measuring salivary function. Current and emerging approaches to treat cancer therapy-induced dry mouth are presented using radiation-induced salivary dysfunction as a model. Limitations of current sialagogues and salivary analogues are presented. Emerging approaches, including cellular and gene therapy and novel pharmacologic approaches, are described.
唾液腺功能障碍是癌症治疗的常见副作用。唾液功能在关键的日常活动中起着关键作用。因此,唾液功能的变化会严重影响癌症患者的生活质量。我们讨论了唾液腺的解剖和生理学,以了解化疗、骨髓移植、免疫疗法和放射疗法等抗癌疗法如何损害唾液功能。我们讨论了在临床上量化口干的方法,包括经过验证的生活质量工具的优缺点,以及直接测量唾液功能的方法。以放射性唾液功能障碍为例,介绍了治疗癌症治疗引起的口干的当前和新兴方法。介绍了当前唾液刺激剂和唾液类似物的局限性。描述了新兴的方法,包括细胞和基因治疗以及新型药物治疗方法。