Xerostomia is one of the most serious late side effects of head and neck radiotherapy.
Xerostomia may also be observed as a result of Graft versus Host Disease in allogeneic HSCT.
Transient xerostomia may be seen in antineoplastic chemotherapy.

Xerostomia may lead to significant decrease in the quality of life of the cancer patient. It causes alterations in taste and difficulties in speech, mastication and deglutition, with secondary nutritional deficiencies and loss of weight.

Rampant dental caries, continuing risk of oral candidiasis and increased risk of osteonecrosis are other important late consequences of xerostomia.

Treatment of xerostomia

Saliva substitutes may be administered, while the teeth should be protected with appropriate fluoride protocols.

The radioprotective agent amifostine (Ethyol) has been shown to preferentially concentrate in the salivary glands, protecting them during radiation.
Amifostine reduces the degree of xerostomia, the incidence of candidiasis, while it protects teeth from dental radiation caries.

Special techniques, such as IMRT, can, also, protect the salivary glands from the toxic effect of radiation.

Selected references

1. Νικολάτου-Γαλίτη Ο. Οι βλάβες του στόματος στον ογκολογικό ασθενή. Εκδόσεις Μπονισσέλ. Αθήνα 2001.
2. Nicolatou-Galitis et al. Oral candidiasis in head and neck cancer patients receiving radiotherapy with amifostine cytoprotection. Oral Oncol 2003;39:397-401.
3. Rudat V et al. Protective effect of amifostine on dental health after radiotherapy of the head and neck. Int J Radiation Oncology Biol Phys 2000;48:1339-1343.