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A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: management strategies and economic impact

Abstract

Purpose

This systematic review aimed to assess the literature for management strategies and economic impact of salivary gland hypofunction and xerostomia induced by cancer therapies and to determine the quality of evidence-based management recommendations.

Methods

The electronic databases of MEDLINE/PubMed and EMBASE were searched for articles published in English since the 1989 NIH Development Consensus Conference on the Oral Complications of Cancer Therapies until 2008 inclusive. For each article, two independent reviewers extracted information regarding study design, study population, interventions, outcome measures, results, and conclusions.

Results

Seventy-two interventional studies met the inclusion criteria. In addition, 49 intensity-modulated radiation therapy (IMRT) studies were included as a management strategy aiming for less salivary gland damage. Management guideline recommendations were drawn up for IMRT, amifostine, muscarinic agonist stimulation, oral mucosal lubricants, acupuncture, and submandibular gland transfer.

Conclusions

There is evidence that salivary gland hypofunction and xerostomia induced by cancer therapies can be prevented or symptoms be minimized to some degree, depending on the type of cancer treatment. Management guideline recommendations are provided for IMRT, amifostine, muscarinic agonist stimulation, oral mucosal lubricants, acupuncture, and submandibular gland transfer. Fields of sparse literature identified included effects of gustatory and masticatory stimulation, specific oral mucosal lubricant formulas, submandibular gland transfer, acupuncture, hyperbaric oxygen treatment, management strategies in pediatric cancer populations, and the economic consequences of salivary gland hypofunction and xerostomia.

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Acknowledgments

We thank Research Librarian Susie Andersen, Deputy Head of the Panum Library, Faculty of Health Sciences, University of Copenhagen, Denmark, for expert assistance with the systematic literature search. We also thank Tainika Williams, Department of Oral Medicine, Carolinas Medical Center, North Carolina, USA, for her overall skills with literature search.

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The authors declared that they have no potential conflicts of interests.

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Jensen, S.B., Pedersen, A.M.L., Vissink, A. et al. A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: management strategies and economic impact. Support Care Cancer 18, 1061–1079 (2010). https://doi.org/10.1007/s00520-010-0837-6

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Keywords

  • Cancer therapy
  • Salivary gland hypofunction
  • Xerostomia
  • Management strategies
  • Economic impact