Supportive Care in Cancer

, Volume 20, Issue 11, pp 2903–2911 | Cite as

Long-term oral effects in patients treated with radiochemotherapy for head and neck cancer

  • Aline Lima da Silva Deboni
  • Adelmo José Giordani
  • Nilza Nelly Fontana Lopes
  • Rodrigo Souza Dias
  • Roberto Araujo Segreto
  • Siri Beier Jensen
  • Helena Regina Comodo Segreto
Original Article



The purpose of this study is to assess the late oral complications and the role of salivary gland hypofunction in the severity of mucosal reaction in nonsurgical head and neck cancer patients, submitted to radiotherapy with or without chemotherapy.

Methods and materials

Five hundred fifteen charts from patients treated between 2005 and 2009 were reviewed, and 41 patients met the inclusion criteria. Salivary gland function was assessed using a simplified grading system (GSX) and sialometry. Late effects were assessed using the Common Toxicity Criteria (CTC Version 2.0).


The average follow-up was 17.1 (4–51) months. A statistical correlation was found for whole salivary flow rates and the average CTC grades for the mucous membrane. Both unstimulated/stimulated whole salivary flow rates (<0.09 mL/min) were identified as potential risk factors (p < 0.05) and an independent predictor for late mucous membrane toxicity (≥grade 2). A significant correlation was also found between unstimulated salivary flow rates—GSX scores (p = 0.001) and CTC grades for salivary glands. Eighty-five percent of the patients were classified as suffering from salivary gland hypofunction, as well as 58.2 % considered dryness of the mouth the most debilitating complication.


Considering the late effects assessed, the salivary gland hypofunction was the most significant and received the highest morbidity graduation (grade 2/grade 3); xerostomia was also considered the most debilitating complication after treatment. Data show the role of salivary gland hypofunction in the severity of late mucous membrane complication.


Radiotherapy Chemotherapy Late effect Head and neck cancer Oral complication 



We are especially grateful for the patients for their participation in this study.

Conflict of interest

The authors report no actual or potential conflict of interest.


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Aline Lima da Silva Deboni
    • 2
  • Adelmo José Giordani
    • 2
  • Nilza Nelly Fontana Lopes
    • 3
  • Rodrigo Souza Dias
    • 2
  • Roberto Araujo Segreto
    • 2
  • Siri Beier Jensen
    • 4
  • Helena Regina Comodo Segreto
    • 1
    • 2
  1. 1.Division of Radiotherapy, Department of Imaging DiagnosisFederal University of São Paulo—UNIFESP/EPMSão PauloBrazil
  2. 2.Division of Radiotherapy, Department of Imaging DiagnosisFederal University of São Paulo—UNIFESP/EPMSão PauloBrazil
  3. 3.Institute of Pediatric OncologyFederal University of São Paulo—IOP/GRAACC/UNIFESPSão PauloBrazil
  4. 4.Department of Oral Medicine, Clinical Oral Physiology, Oral Pathology & Anatomy, Institute of Odontology, Faculty of Health SciencesUniversity of CopenhagenCopenhagenDenmark

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