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. 2013 Jun;115(6):772-9.
doi: 10.1016/j.oooo.2013.01.006. Epub 2013 Mar 22.

Analysis of factors influencing the development of xerostomia during intensity-modulated radiotherapy

Ken Randall  1 , Jason Stevens, Juan Fernando Yepes, Marcus E Randall, Mahesh Kudrimoti, Jonathan Feddock, Jing Xi, Richard J Kryscio, Craig S Miller
Affiliations

Analysis of factors influencing the development of xerostomia during intensity-modulated radiotherapy

Ken Randall et al. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Jun.

Abstract

Objectives: Factors influencing xerostomia during intensity-modulated radiation therapy (IMRT) were assessed.

Methods: A 6-week study of 32 head and neck cancer (HNC) patients was performed. Subjects completed the Xerostomia Inventory (XI) and provided stimulated saliva (SS) at baseline, week 2 and at end of IMRT. Influence of SS flow rate (SSFR), calcium and mucin 5b (MUC5b) concentrations and radiation dose on xerostomia was determined.

Results: HNC subjects experienced mean SSFR decline of 36% by visit 2 (N = 27; P = .012) and 57% by visit 3 (N = 20; P = .0004). Concentrations of calcium and MUC5b increased, but not significantly during IMRT (P > .05). Xerostomia correlated most with decreasing salivary flow rate as determined by Spearman correlations (P < .04) and linear mixed models (P < .0001).

Conclusions: Although IMRT is sparing to the parotid glands, it has an early effect on SSFR and the constituents in saliva in a manner that is associated with the perception of xerostomia.

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Conflict of interest statement

Conflict of interest: The authors report no conflicts of interest related to this study.

Figures

Figure 1
Figure 1
Fourteen question xerostomia inventory (XI).
Figure 2
Figure 2
Boxplots of salivary flow rate by visit. SSFR is calculated by taking the volume shown divided by eight minutes (i.e., collection time). Red plus is the mean. Open squares are outliers. * p=0.012 compared with Visit 1. ‡ p=0.0004 compared with Visit 1.
Figure 3
Figure 3
Boxplots of saliva calcium concentration by visit. Red plus is the mean. Open squares are outliers.
Figure 4
Figure 4
Boxplots of saliva MUC5b concentration by visit. Red plus is the mean. Open squares are outliers.
Figure 5
Figure 5
Boxplots of total XI scores by visit. Maximum score possible = 70. Red plus is the mean. Open squares are outliers. * p<0.001 compared with Visit 1. ‡ p=0.001 compared with Visit 2.
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