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Title: A longitudinal study on radiation induced xerostomia in radiotherapy of nasopharyngeal carcinoma patients
Authors: Wu, VWC 
Ying, MTC 
Kwong, DLW
Khong, PL
Wong, GKW
Tam, SY 
Issue Date: 2020
Source: Journal of cancer science and therapy, 2020, v. 12, no. 6, p. 1-5
Abstract: Background: Xerostomia is the most common post-radiotherapy (post-RT) complication in nasopharyngeal carcinoma (NPC) patients. This longitudinal study evaluated the impact of radiotherapy on saliva flow rate of major salivary glands and patients’ quality of life due to xerostomia.
Methods: 27 NPC patients treated by intensity modulated radiotherapy in 2018 were recruited. Resting saliva flow rates of individual saliva gland including parotid and submandibular glands were measured before radiotherapy, at 6-month, 12-month and 18-month post-radiotherapy (postRT). At the same time points, patients’ feedback on the severity of xerostomia was obtained from a validated questionnaire. Trend lines of the saliva flow rate and questionnaire scores were plotted, and the correlations of salivary gland doses and the percentage change of saliva flow rate at the time of greatest impact were also investigated.
Results: Similar doses were received by the parotid gland and submandibular gland. The saliva flow rates of the parotid gland and submandibular gland showed significant decrease of over 80% at 6 months post-RT and stayed at similar low level thereafter. There was no significant correlation between post-RT saliva flow rate changes and mean doses received by the glands. For the xerostomia questionnaire scores, the feelings of dryness and comfortability of mouth deteriorated significantly at 6 months post-RT. Great impacts of xerostomia on sleeping, speaking, eating and wearing dentures were also observed at 6 months post-RT and they remained fairly constant afterward.
Conclusion: The average mean doses to parotid and submandibular glands were around 35 Gy in IMRT of NPC patients, which significantly reduced the saliva flow rates of the parotid and submandibular glands. The impact was greatest at 6 months post-RT and was long lasting. Patients’ quality of life was affected by the severity of xerostomia and the effects showed similar pattern as the saliva flow rates.
Keywords: Saliva flow rate
Nasopharyngeal carcinoma
Radiation-induced changes
Publisher: Hilaris
Journal: Journal of cancer science and therapy 
EISSN: 1948-5956
DOI: 10.37421/jcst.2020.12.343
Rights: © 2020 Wu VWC, et al. This is an open-access article distributed under the terms of the creative commons attribution license which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
The following publication VWC, W., Ying, M. T., Kwong, D. L., Khong, P. L., Wong, G. K., & Tam, S. Y. (2020). A longitudinal study on radiation induced xerostomia in radiotherapy of nasopharyngeal carcinoma patients. J Can Sc Thera, 12(1), 1-6 is available at
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