Management of Radiation Induced Xerostomia

Xerostomia describes both the subjective sensation of oral dryness and the objective reduction in salivary function. Most oncology patients experience oral dryness, at least temporarily during the trajectory of their illness and treatment. In fact, almost all head and neck cancer patients undergoing radiotherapy experience some degree of xersostomia (Chambers, Rosenthal & Weber, 2007). Inadequate salivary function creates multiple complications, including poor dentition, a propensity to oral infections, sleep disturbances, oral pain, and difficulty talking, chewing and swallowing (Deasy et al., 2010). Radiation therapy is the most common source of treatment-related xerostomia in cancer. The degree of permanence and severity directly correlates with the amount of radiation dose delivered to the salivary glands (Deasy et al., 2010). The use of concurrent chemo-radiation compounds damage to salivary glands and increases the risk of long-term salivary dysfunction (Bhide, Miah, Harrington, Newbold & Nutting, 2009). Concurrent chemo-radiation dramatically increases the incidence of salivary gland dysfunction (by about 70%) when compared to radiation alone (Bhide et al., 2009). In addition, agents including 5-fluorouracil, cisplatin, bleomycin, methotrexate, doxorubicin, cyclophosphamide, and vinblastine are all independently associated with dry mouth (Camp-Sorrell, 2005).