Xerostomia after radiotherapy and its effect on quality of life in head and neck cancer patients.

Kerman Neuroscience Research Center, Kerman, Iran.
Archives of Iranian medicine (Impact Factor: 1.11). 04/2012; 15(4):214-8.
Source: PubMed

ABSTRACT Xerostomia is one of the one complications following radiotherapy that can affect quality of life (QoL). This study aims to assess the severity of xerostomia in patients with head and neck cancers after radiotherapy and its effect on QoL.
In this longitudinal prospective study, the severity of xerostomia and related QoL were was assessed in 63 head and neck cancer patients who referred to the Radiotherapy Ward. Patients completed a xerostomia questionnaire (XQ) at the beginning, and 2, 4, and 6 weeks after treatment over a period of 6 months. Additionally, unstimulated saliva was collected using the spitting method at all 4 visits.
QoL significantly worsened with increased time (P = 0.0001); meanwhile, the severity of xerostomia increased significantly (P = 0.0001). However, there was no significant change in the amount of saliva at these 4 time points (P = 0.23). Regression analysis showed that with each milliliter decrease in saliva secretion, the QoL score decreased 2.25%. With one score increase in xerostomia, from the QoL mean score there was a 1.65% decrease.
The decrease in saliva and xerostomia that resulted from radiotherapy plays an important role in worsening QoL among patients who undergo radiotherapy for head and neck cancers. Although the amount of saliva has a significant association with QoL, the xerostomia score which shows subjects' general feeling also independently impacts QoL. In future studies, we recommend patient assessments for periods longer than 6 months.

1 Bookmark
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Radiotherapy remains the major course of treatment for Head and Neck cancer patients. A common consequence of radiation treatment is dysfunction of the salivary glands, which leads to a number of oral complications including xerostomia and dysphagia, for which there is no existent cure. Here, we briefly describe the current palliative treatments available for patients undergoing these conditions, such as oral lubricants, saliva substitutes, and saliva stimulants. None of these options achieves restoration of normal quality of life due to their limited effectiveness, and in some cases, adverse side effects of their own. Other therapies under development, such as acupuncture and electrostimulation have also yielded mixed results in clinical trials. Due to the ineffectiveness of palliative care to restore quality of life, it is reasonable to aim for the development of regenerative therapies that allow restoration of function of the salivary epithelium following radiation treatment. Adult stem cells are a necessary component of wound healing, and play important roles in preserving normal function of adult tissues. Thus, the present review mainly focuses on the effects of radiation on adult stem cells in a variety of tissues, which may be at play in the response of salivary glands to radiation treatment. This is of clinical importance because progenitor cells of the salivary glands have shown partial regenerative potential in mouse transplantation assays. Therefore, understanding how these progenitor cells are affected by radiation offers potential for development of new therapies for patients with xerostomia.
    Journal of palliative care 08/2014; 4(4):180. DOI:10.4172/2165-7386.1000180 · 0.80 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose Xerostomia is the most common acute and late side effect of radiation treatment for head and neck cancer. Affecting taste perception, chewing, swallowing and speech, xerostomia is also the major cause of decreased quality of life. The aims of this study were to validate the Italian translation of the self-reported eight-item xerostomia questionnaire (XQ) and determine its psychometric properties in patients treated with radiotherapy for head and neck cancer. Methods An observational cross-sectional study was conducted in the Radiotherapy Unit of the Veneto Institute of Oncology – IOV in Padua. The XQ was translated according to international guidelines and filled out by 102 patients. Construct validity was assessed using principal component analysis, internal consistency using Cronbach’s α coefficient and test-retest reliability at 1-month interval using the intraclass correlation coefficient (ICC). Criterion-related validity was evaluated to compare the Italian version of XQ with the European Organization for Research and Treatment of Cancer (EORTC) Core Quality-of-Life Questionnaire (QLQ-C30) and its Head and Neck Cancer Module (QLQ-H&N35). Results Cronbach’s α for the Italian version of XQ was strong at α = 0.93, test-retest reliability was also strong (0.79) and factor analysis confirmed that the questionnaire was one-dimensional. Criterion-related validity was excellent with high association with the EORTC QLQ-H&N35 xerostomia and sticky saliva scales. Conclusions The Italian version of XQ has excellent psychometric properties and can be used to evaluate the impact of emerging radiation delivery techniques aiming at preventing xerostomia.
    Supportive Care Cancer 09/2014; 23(4). DOI:10.1007/s00520-014-2438-2 · 2.50 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to evaluate health-related quality of life (HRQOL) in patients with different body mass indices (BMI, <25 vs ≥25) undergoing radiation treatment for head and neck cancer.
    Supportive Care Cancer 10/2014; 23(4). DOI:10.1007/s00520-014-2463-1 · 2.50 Impact Factor


Available from
May 21, 2014