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Dramatic and prolonged decrease of whole salivary secretion in nasopharyngeal carcinoma patients treated with radiotherapy.

Yee-Min Jen·Yu-Ching Lin·Yi-Bing Wang·Der-Min Wu
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Abstract

OBJECTIVES: This study evaluates: (1) the change in whole salivary secretion rates of nasopharyngeal carcinoma patients before, during, and after radiotherapy, especially during the first week of irradiation; (2) the recovery capability of salivary glands up to 2 years postirradiation; and (3) the possible prognostic factors affecting salivary gland functions. STUDY DESIGN: Fifty patients who completed conventional radiotherapy using either once-per-day or hyperfractionated technique were included. Both unstimulated and stimulated whole salivary flow rates and ratios (flow rate compared with baseline) were measured before, during, 1, 3, and 6 months, and 1 and 2 years after radiotherapy. Multivariate analysis of potential prognostic factors affecting the salivary secretion ratio was made. RESULTS: Salivary glands were very radiosensitive and responded to radiation very early. After 720 cGy at the fourth day of the 8-week treatment, the unstimulated and stimulated salivary flow rates had decreased by 40%-50%. The nadir was reached in many patients after 3600 cGy (4 weeks). A second phase of decrease in salivary secretion was noted after completion of radiotherapy. CONCLUSIONS: Different mechanisms may be responsible for salivary response after low and high dose of radiation. This study shows no recovery of salivary secretion during the follow-up period, and the best strategy for managing radiation-induced salivary gland damage may be reduction of radiation dose to the glands.

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AdolescentAdultAgedCranial IrradiationDose-Response Relationship, RadiationFemaleHumansMaleMiddle AgedMultivariate AnalysisNasopharyngeal NeoplasmsRadiation InjuriesRadiotherapy DosageSalivaSalivary GlandsSalivationSecretory RateXerostomiaJournal ArticleResearch Support, Non-U.S. Gov't

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Yee-Min Jen, Yu-Ching Lin, Yi-Bing Wang, Der-Min Wu. 2005-10-14. Dramatic and prolonged decrease of whole salivary secretion in nasopharyngeal carcinoma patients treated with radiotherapy.. https://doi.org/10.1016/j.tripleo.2005.01.011

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