Radiation-induced xerostomia

BACKGROUND: Radiation-induced xerostomia is a frequent and usually permanent side effect of radiation therapy for head and neck cancer. We summarize recent developments in the prevention and treatment of radiation-induced xerostomia. METHODS: The Medline database was searched for articles published within the past 10 years on the prevention and treatment of postirradiation xerostomia. Proceedings of recent important national meetings and government Web registries of clinical trials and therapeutic agents were also consulted. Priority was given to randomized controlled trials but, because of the scarcity of such trials, small open trials were included in this review. No other predetermined selection criteria were used, although articles exploring the effects of xerostomia and its treatment on quality of life were considered of special interest. RESULTS: A variety of preventive approaches for postirradiation xerostomia exist, involving more conformal radiation delivery technology, radioprotective agents, and even preirradiation surgical techniques. Therapeutic interventions include supportive care, saliva supplementation, and the use of pro-cholinergic salivary secretagogues. CONCLUSIONS: Radiation-induced xerostomia constitutes a significant morbidity after orofacial irradiation. Careful preventive techniques, meticulous supportive care, and new preventive and therapeutic agents may prove useful in combination.