Xerostomia, or dry mouth, is a significant problem affecting quality of life in patients treated with radiation therapy for head and neck cancer. Strategies for reduction of xerostomia burden vary widely, with options...Xerostomia, or dry mouth, is a significant problem affecting quality of life in patients treated with radiation therapy for head and neck cancer. Strategies for reduction of xerostomia burden vary widely, with options including: sialagogue medications, saliva substitutes, acupuncture, vitamins, hyperbaric oxygen,submandibular gland transfer, and acupuncture or associated treatments. In this review, we sought to evaluate long-term outcomes of patients treated with various interventions for radiation-induced xerostomia. A literature search was performed using the terms "xerostomia" and "radiation" or "radiotherapy"; all prospective clinical trials were evaluated, and only studies that reported 1 year follow up were included. The search results yielded 2193 studies, 1977 of which were in English. Of those, 304 were clinical trials or clinical studies. After abstract review, 23 trials were included in the review evaluating the following treatment modalities: pilocarpine(three); cevimeline(one); amifostine(eleven);submandibular gland transfer(five); acupuncture like transcutaneous electrical nerve stimulation(ALTENS)(one); hyperbaric oxygen(one); and acupuncture(one). Pilocarpine, cevimeline, and amifostine have been shown in some studies to improve xerostomia outcomes, at the cost of toxicity. ALTENS has similar efficacy with fewer side effects. Submandibular gland transfer is effective but requires an elective surgery, and thus may not always be appropriate or practical.The use of intensity-modulated radiation therapy, in addition to dose deescalation in select patients, may result in fewer patients with late xerostomia,reducing the need for additional interventions.展开更多
Purpose: Investigation of the influence of radiation dose to salivary glands on xerostomia in patients with head and neck cancers. Methods: From October 2002 to December 2011, 548 patients with head and neck carcinoma...Purpose: Investigation of the influence of radiation dose to salivary glands on xerostomia in patients with head and neck cancers. Methods: From October 2002 to December 2011, 548 patients with head and neck carcinomas were treated in our department using intensity modulated radiotherapy (IMRT). 325 patients were eligible for analysis more than 1 year after irradiation. Xerostomia was evaluated according to the criteria of Radiation Therapy and Oncology Group (RTOG) and xerostomia related questionnaire. For statistical analysis grade 1 and 2 were recorded as mild and grade 3 and 4 as severe xerostomia. The dosimetric values for absolute mean dose, biological equivalent mean dose (EQD2), the relative organ volume not exceeding 20 Gy, 25 Gy and 30 Gy (V20, V25, V30) for all 4 major salivary glands or for both parotid glands only were used for analysis. V20 revealed the best discrimination between both patient groups (with vs. without xerostomia), compared to parameters V25 and V30. Therefore the volume of the salivary glands receiving less than 20 Gy (V 20Gy) was analyzed additionally. Mann-Whitney-U-test, Kruskal-Wallis-test and logistic regression were used in statistical analysis. Results: A TD 50 can be determined for the occurrence of xerostomia more than one year after radiotherapy for both parotid glands of 19.3 Gy for the mean dose absolute, 11.2 Gy for the mean dose EQD2, 38.2% for V20, 26.8% for V25, 18.7% for V30, 34.9 ml for V 20Gy. For all major salivary glands theses values were 25.7 Gy for the mean dose absolute, 15.6 Gy for the mean dose EQD2, 51.3% for V20, 41.1% for V25, 33.9% for V30 and 34.8 ml for V 20Gy. Conclusions: The identification of a tolerance dose for the salivary glands for treatment planning appears to be difficult, as the dose-response correlation only shows a flat slope. Additionally, a large interindividual variability seems to exist. We could not found any threshold dose for development of xerostomia.展开更多
Background: The sixth most prevalent cancer in the world is head and neck squamous cell carcinoma (HNSCC). In multiple combinations, surgery, radiation and chemotherapy are used in HNC control. As radiation-induced sa...Background: The sixth most prevalent cancer in the world is head and neck squamous cell carcinoma (HNSCC). In multiple combinations, surgery, radiation and chemotherapy are used in HNC control. As radiation-induced salivary gland damage and xerostomia is one of the most usual and distressing impacts,?diffusion-weighted magnetic resonance imaging (DW-MRI) is a promising technique for the assessment of alterations due to radiation therapy.?The aim of the study is?to evaluate the effect of Chemoradiotherapy either concurrent or sequential/RTH on salivary glands using DW-MRI performed before and after chemoradiotherapy/RTH,?correlation between DW-MRI changes?and delivered radiation dose to salivary glands,?study the acute toxicity of chemoradiotherapy/RTH on salivary glands and assess quality of life for patients with radiation-induced xerostomia.?Patients and Methods: This prospective study included 43 patients with Head and Neck squamous cell carcinoma treated with definitive radiotherapy, sequential therapy or concurrent chemoradiotherapy at Clinical Oncology and Nuclear Medicine Department, MRI diffusion scans were done at Diagnostic Radiology Department Tanta University Hospitals throughout the period from May 2016 to May 2019.?DW-MRI performed before and after RTH. For patients receiving CCRTH, DW sequence will be performed before starting RTH and 2?-?3 months post-RTH once at rest and then repeated continuously during salivary stimulation by ascorbic acid. In case of induction chemotherapy, DW-MRI was done before and after induction and 2?-?3 months post-RTH.?Results:?In all time periods, ADC values were lower for the PG than the SMG.?ADC change of PGs was higher in hypopharyngeal carcinoma, while ADC change of SMGs?were?higher in oropharyngeal carcinoma.?ADC change in PGs & SMGs was higher in advanced stage.?Conclusion:?To assess the radiation-induced xerostomia, DW-MRI can be used as non-invasive tool. Xerostomia questionnaire is helpful instrument for evaluating of quality of life for patients with radiation-induced xerostomia. There was a significant correlation between xerostomia and quality of life.展开更多
Based on the findings of epidemiological surveys in western countries, the number of person with suspected xerostomia in Japan is estimated to be 30,000,000. Xerostomia is caused by: 1) Systemic diseases;2) Medication...Based on the findings of epidemiological surveys in western countries, the number of person with suspected xerostomia in Japan is estimated to be 30,000,000. Xerostomia is caused by: 1) Systemic diseases;2) Medications;3) Tumors or trauma;4) Radiotherapy;and 5) Neurological factors. Its symptoms can be alleviated, and its progression can be stopped by close cooperation between the dental and medical departments. However, at present, symptomatic treatment methods such as water drinking, oral rinsing with water, and administration of Kampo medicines or parasymptomimetic drugs are mainly used, and a standard treatment has not been established. On the other hand, previous studies on xerostomia have reported improvement in dry mouth symptoms using dental approaches or a relationship between the development of candidiasis and the salivary flow rate. Therefore, in this study, to establish a dental method useful for improving xerostomia associated with systemic diseases and medications for them, we restored occlusal function, and as a result, increased the salivary flow rate, and evaluated changes in oral findings.展开更多
目的:采用Meta分析的方法,评价咀嚼无糖口香糖对血液透析患者口腔干燥症干预的效果。方法:检索中国知网、万方、维普、中国生物医学、Pubmed、Embase、Cochance、Web of science、Ovid及CINAHL数据库中有关咀嚼无糖口香糖对血液透析患...目的:采用Meta分析的方法,评价咀嚼无糖口香糖对血液透析患者口腔干燥症干预的效果。方法:检索中国知网、万方、维普、中国生物医学、Pubmed、Embase、Cochance、Web of science、Ovid及CINAHL数据库中有关咀嚼无糖口香糖对血液透析患者口腔干燥症干预效果的随机对照试验或半随机临床试验。将符合纳入、排除标准的研究进行数据提取和质量评价后,使用Review Manager 5.3软件对结局指标进行Meta分析。结果:共纳入5项研究,包括237名患者。结果显示,咀嚼无糖口香糖能改善患者的口干症状[MD=-2.12,95%CI(-2.53,-1.71),P<0.001];但对患者透析间的口渴症状[MD=-1.57,95%CI(-3.41,0.27),P=0.09]和体重增加[MD=-0.38,95%CI(-1.02,0.27),P=0.25]没有影响。结论:咀嚼无糖口香糖对血液透析患者的口干症状有所改善,但对患者透析间口渴症状和体重增加无影响。但由于本研究纳入的文献数量较少,且文献质量不高,因此仍需开展大样本、多中心的高质量随机对照试验,以进一步探讨咀嚼无糖口香糖对血液透析患者口腔干燥症的干预效果。展开更多
Objective:To explore the value of radiomics features extracted from the T2-weighted imaging(T2WI)images of parotids in predicting late radiation-induced xerostomia in nasopharyngeal carcinoma(NPC)patients after radiot...Objective:To explore the value of radiomics features extracted from the T2-weighted imaging(T2WI)images of parotids in predicting late radiation-induced xerostomia in nasopharyngeal carcinoma(NPC)patients after radiotherapy(RT).Methods:A retrospective analysis was conducted for 123 NPC patients who received RT at the Affiliated Tumour Hospital of Xinjiang Medical University from January 2019 to March 2021.All the patients underwent MRI pre-RT and post-RT.They were randomly divided into a training set and a testing set at a ratio of 4:1 using a random number table,with the former and the latter comprising 98 and 25 cases,respectively.The ipsilateral parotid gland(iPG)and the contralateral parotid gland(cPG)were delineated on T2WI images pre-RT and post-RT as regions of interest(ROIs).A total of 851 radiomics features were extracted from each ROI.Spearman analysis was used to remove redundant features,and the recursive feature elimination(RFE)method was then used to determine useful features.Using radiomics features extracted from images pre-treatment,images post-treatment,and differences between images pre-and post-treatment,this study constructed three radiomic models,namely the pre-treatment radiomics model(preRT),the post-treatment radiomics model(postRT),and the deltaradiomics model(DeltaRT).Then,this study plotted the receiver operating characteristic(ROC)curves based on the late radiation-induced xerostomia grades of patients post-RT.Furthermore,the models’effectiveness and performance in predicting late radiation-induced xerostomia and advanced radioactive xerostomia was evaluated.In addition,the area under the curve(AUC),sensitivity,specificity,accuracy,precision,and negative predictive value(NPV)were calculated.Results:Among the features extracted from bilateral parotid glands(PGs),20 were determined pre-RT(six from iPG and 14 from cPG),19 were determined post-RT(six from iPG and 13 from cPG),and 20 were derived from the DeltaRT(20 from cPG).The PGs pre-RT and post-RT in the training set had AUCs of 0.902(95%CI:0.895-0.909)and 0.761(95%CI:0.744-0.778),respectively,while those in the testing set had AUCs of 0.740(95%CI:0.504-0.983)and 0.701(95%CI:0.478-0.924),respectively.In contrast,the AUC of the cPG derived from the DeltaRT was 0.867(95%CI:0.856-0.878)in the training set and 0.851(95%CI:0.697-0.999)in the testing set.Conclusions:There are significant correlations between radiomics features extracted from MRI T2WI images of parotids and late radiation-induced xerostomia in NPC patients.Among the radiomics features,the changes in cPG features pre-RT and post-RT have higher accuracy in predicting late radiation-induced xerostomia.展开更多
Objective: To assess the relative standardization of acupuncture protocols for radiation-induced xerostomia. Methods: A literature search was carried out up to November 10, 2012 in the databases PubMed/ MEDLINE, EMB...Objective: To assess the relative standardization of acupuncture protocols for radiation-induced xerostomia. Methods: A literature search was carried out up to November 10, 2012 in the databases PubMed/ MEDLINE, EMBASE and China National Knowledge Infrastruction with the terms: radiation-induced xerostomia, acupuncture, acupuncture treatment, and acupuncture therapy. Five ancient Chinese classic acupuncture works were also reviewed with the keywords "dry mouth, thirst, dry tongue, dry eyes and dry lips" to search the effective acupuncture points for dry mouth-associated symptoms in ancient China. Results: Twenty-two full-text articles relevant to acupuncture treatment for radiation-induced xerostomia were included and a total of 48 acupuncture points were searched in the 5 ancient Chinese classic acupuncture works, in which the most commonly used points were Chengjiang (CV24), Shuigou (GV 26), Duiduan (GV 27), Jinjin (EX-HN 12), and Yuye (EX-HN 13) on head and neck, Sanjian (LI 3), Shangyang (LI 1), Shaoshang (LU 11), Shaoze (SI 1), Xialian (LI 8) on hand, Fuliu (KI 7), Dazhong (KI 4), Zuqiaoyin (GB 44), Taichong (LR 3), Zhaohai (KI 6) on foot, Burong (ST 19), Zhangmen (LR 13), Tiantu (CV 22), Qimen (LR 14) on abdomen, Feishu (BL 13), Danshu (BL 19), Xiaochaogshu (BL 27), Ganshu (BL 18) on back, Shenmen (TF 4), Shen (CO10, Kidney), Yidan (CO11, Pancreas) and Pi (CO13, Spleen) on ear. Conclusion: There were considerable heterogeneities in the current acupuncture treatment protocols for radiation-induced xerostomia. Based on the results of the review and the personal perspectives, the authors provide a recommendation for manual acupuncture protocols in treating radiationinduced xerostomia patients with head and neck cancer.展开更多
BACKGROUND: Xerostomia is one of the most common side effects of radiation therapy among patients with head and neck cancers (HNC). However, conventional medicine lacks an effective treatment for radiation-induced ...BACKGROUND: Xerostomia is one of the most common side effects of radiation therapy among patients with head and neck cancers (HNC). However, conventional medicine lacks an effective treatment for radiation-induced xerostomia. OBJECTIVE: Synthesizing the traditional use ofAIcea digitata and Malva sylvestris with their known beneficial effects from recent studies, we evaluated the efficacy of the herbs in the quality of life (QOL) of HNC patients with radiation-induced xerostomia. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This study is a randomized, double-arm, open-label active-controlled clinical trial. We evaluated the effect ofA. digitata and M. sy/vestris on QOL of HNC patients with radiation-induced xerostomia compared with Hypozalix (artificial saliva). Patients were enrolled from the Imam Hossein Hospital's oncology clinic in Shahid Beheshti University of Medica Sciences. Tehran, Iran. MAIN OUTCOME MEASURES: Primary outcome measures in this trial were changes in patients' QOL assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Head and Neck Module (EORTC QLQ-H&N 35). RESULTS: Between-group analysis showed that the intervention group patients obtained significantly lower (better) total EORTC QLQ-H&N 35 scores as compared to the control group at the end of the intervention period (P = 0.007). Mean scores of dry mouth of EORTC QLQ-H&N 35 was also significantly lower (better) in the intervention group as compared to the control group (P = 0.017).展开更多
文摘Xerostomia, or dry mouth, is a significant problem affecting quality of life in patients treated with radiation therapy for head and neck cancer. Strategies for reduction of xerostomia burden vary widely, with options including: sialagogue medications, saliva substitutes, acupuncture, vitamins, hyperbaric oxygen,submandibular gland transfer, and acupuncture or associated treatments. In this review, we sought to evaluate long-term outcomes of patients treated with various interventions for radiation-induced xerostomia. A literature search was performed using the terms "xerostomia" and "radiation" or "radiotherapy"; all prospective clinical trials were evaluated, and only studies that reported 1 year follow up were included. The search results yielded 2193 studies, 1977 of which were in English. Of those, 304 were clinical trials or clinical studies. After abstract review, 23 trials were included in the review evaluating the following treatment modalities: pilocarpine(three); cevimeline(one); amifostine(eleven);submandibular gland transfer(five); acupuncture like transcutaneous electrical nerve stimulation(ALTENS)(one); hyperbaric oxygen(one); and acupuncture(one). Pilocarpine, cevimeline, and amifostine have been shown in some studies to improve xerostomia outcomes, at the cost of toxicity. ALTENS has similar efficacy with fewer side effects. Submandibular gland transfer is effective but requires an elective surgery, and thus may not always be appropriate or practical.The use of intensity-modulated radiation therapy, in addition to dose deescalation in select patients, may result in fewer patients with late xerostomia,reducing the need for additional interventions.
文摘Purpose: Investigation of the influence of radiation dose to salivary glands on xerostomia in patients with head and neck cancers. Methods: From October 2002 to December 2011, 548 patients with head and neck carcinomas were treated in our department using intensity modulated radiotherapy (IMRT). 325 patients were eligible for analysis more than 1 year after irradiation. Xerostomia was evaluated according to the criteria of Radiation Therapy and Oncology Group (RTOG) and xerostomia related questionnaire. For statistical analysis grade 1 and 2 were recorded as mild and grade 3 and 4 as severe xerostomia. The dosimetric values for absolute mean dose, biological equivalent mean dose (EQD2), the relative organ volume not exceeding 20 Gy, 25 Gy and 30 Gy (V20, V25, V30) for all 4 major salivary glands or for both parotid glands only were used for analysis. V20 revealed the best discrimination between both patient groups (with vs. without xerostomia), compared to parameters V25 and V30. Therefore the volume of the salivary glands receiving less than 20 Gy (V 20Gy) was analyzed additionally. Mann-Whitney-U-test, Kruskal-Wallis-test and logistic regression were used in statistical analysis. Results: A TD 50 can be determined for the occurrence of xerostomia more than one year after radiotherapy for both parotid glands of 19.3 Gy for the mean dose absolute, 11.2 Gy for the mean dose EQD2, 38.2% for V20, 26.8% for V25, 18.7% for V30, 34.9 ml for V 20Gy. For all major salivary glands theses values were 25.7 Gy for the mean dose absolute, 15.6 Gy for the mean dose EQD2, 51.3% for V20, 41.1% for V25, 33.9% for V30 and 34.8 ml for V 20Gy. Conclusions: The identification of a tolerance dose for the salivary glands for treatment planning appears to be difficult, as the dose-response correlation only shows a flat slope. Additionally, a large interindividual variability seems to exist. We could not found any threshold dose for development of xerostomia.
文摘Background: The sixth most prevalent cancer in the world is head and neck squamous cell carcinoma (HNSCC). In multiple combinations, surgery, radiation and chemotherapy are used in HNC control. As radiation-induced salivary gland damage and xerostomia is one of the most usual and distressing impacts,?diffusion-weighted magnetic resonance imaging (DW-MRI) is a promising technique for the assessment of alterations due to radiation therapy.?The aim of the study is?to evaluate the effect of Chemoradiotherapy either concurrent or sequential/RTH on salivary glands using DW-MRI performed before and after chemoradiotherapy/RTH,?correlation between DW-MRI changes?and delivered radiation dose to salivary glands,?study the acute toxicity of chemoradiotherapy/RTH on salivary glands and assess quality of life for patients with radiation-induced xerostomia.?Patients and Methods: This prospective study included 43 patients with Head and Neck squamous cell carcinoma treated with definitive radiotherapy, sequential therapy or concurrent chemoradiotherapy at Clinical Oncology and Nuclear Medicine Department, MRI diffusion scans were done at Diagnostic Radiology Department Tanta University Hospitals throughout the period from May 2016 to May 2019.?DW-MRI performed before and after RTH. For patients receiving CCRTH, DW sequence will be performed before starting RTH and 2?-?3 months post-RTH once at rest and then repeated continuously during salivary stimulation by ascorbic acid. In case of induction chemotherapy, DW-MRI was done before and after induction and 2?-?3 months post-RTH.?Results:?In all time periods, ADC values were lower for the PG than the SMG.?ADC change of PGs was higher in hypopharyngeal carcinoma, while ADC change of SMGs?were?higher in oropharyngeal carcinoma.?ADC change in PGs & SMGs was higher in advanced stage.?Conclusion:?To assess the radiation-induced xerostomia, DW-MRI can be used as non-invasive tool. Xerostomia questionnaire is helpful instrument for evaluating of quality of life for patients with radiation-induced xerostomia. There was a significant correlation between xerostomia and quality of life.
文摘Based on the findings of epidemiological surveys in western countries, the number of person with suspected xerostomia in Japan is estimated to be 30,000,000. Xerostomia is caused by: 1) Systemic diseases;2) Medications;3) Tumors or trauma;4) Radiotherapy;and 5) Neurological factors. Its symptoms can be alleviated, and its progression can be stopped by close cooperation between the dental and medical departments. However, at present, symptomatic treatment methods such as water drinking, oral rinsing with water, and administration of Kampo medicines or parasymptomimetic drugs are mainly used, and a standard treatment has not been established. On the other hand, previous studies on xerostomia have reported improvement in dry mouth symptoms using dental approaches or a relationship between the development of candidiasis and the salivary flow rate. Therefore, in this study, to establish a dental method useful for improving xerostomia associated with systemic diseases and medications for them, we restored occlusal function, and as a result, increased the salivary flow rate, and evaluated changes in oral findings.
文摘目的:采用Meta分析的方法,评价咀嚼无糖口香糖对血液透析患者口腔干燥症干预的效果。方法:检索中国知网、万方、维普、中国生物医学、Pubmed、Embase、Cochance、Web of science、Ovid及CINAHL数据库中有关咀嚼无糖口香糖对血液透析患者口腔干燥症干预效果的随机对照试验或半随机临床试验。将符合纳入、排除标准的研究进行数据提取和质量评价后,使用Review Manager 5.3软件对结局指标进行Meta分析。结果:共纳入5项研究,包括237名患者。结果显示,咀嚼无糖口香糖能改善患者的口干症状[MD=-2.12,95%CI(-2.53,-1.71),P<0.001];但对患者透析间的口渴症状[MD=-1.57,95%CI(-3.41,0.27),P=0.09]和体重增加[MD=-0.38,95%CI(-1.02,0.27),P=0.25]没有影响。结论:咀嚼无糖口香糖对血液透析患者的口干症状有所改善,但对患者透析间口渴症状和体重增加无影响。但由于本研究纳入的文献数量较少,且文献质量不高,因此仍需开展大样本、多中心的高质量随机对照试验,以进一步探讨咀嚼无糖口香糖对血液透析患者口腔干燥症的干预效果。
基金supported by the Central Guidance on Local Science and Technology Development Fund,China(ZYYD2022B18).
文摘Objective:To explore the value of radiomics features extracted from the T2-weighted imaging(T2WI)images of parotids in predicting late radiation-induced xerostomia in nasopharyngeal carcinoma(NPC)patients after radiotherapy(RT).Methods:A retrospective analysis was conducted for 123 NPC patients who received RT at the Affiliated Tumour Hospital of Xinjiang Medical University from January 2019 to March 2021.All the patients underwent MRI pre-RT and post-RT.They were randomly divided into a training set and a testing set at a ratio of 4:1 using a random number table,with the former and the latter comprising 98 and 25 cases,respectively.The ipsilateral parotid gland(iPG)and the contralateral parotid gland(cPG)were delineated on T2WI images pre-RT and post-RT as regions of interest(ROIs).A total of 851 radiomics features were extracted from each ROI.Spearman analysis was used to remove redundant features,and the recursive feature elimination(RFE)method was then used to determine useful features.Using radiomics features extracted from images pre-treatment,images post-treatment,and differences between images pre-and post-treatment,this study constructed three radiomic models,namely the pre-treatment radiomics model(preRT),the post-treatment radiomics model(postRT),and the deltaradiomics model(DeltaRT).Then,this study plotted the receiver operating characteristic(ROC)curves based on the late radiation-induced xerostomia grades of patients post-RT.Furthermore,the models’effectiveness and performance in predicting late radiation-induced xerostomia and advanced radioactive xerostomia was evaluated.In addition,the area under the curve(AUC),sensitivity,specificity,accuracy,precision,and negative predictive value(NPV)were calculated.Results:Among the features extracted from bilateral parotid glands(PGs),20 were determined pre-RT(six from iPG and 14 from cPG),19 were determined post-RT(six from iPG and 13 from cPG),and 20 were derived from the DeltaRT(20 from cPG).The PGs pre-RT and post-RT in the training set had AUCs of 0.902(95%CI:0.895-0.909)and 0.761(95%CI:0.744-0.778),respectively,while those in the testing set had AUCs of 0.740(95%CI:0.504-0.983)and 0.701(95%CI:0.478-0.924),respectively.In contrast,the AUC of the cPG derived from the DeltaRT was 0.867(95%CI:0.856-0.878)in the training set and 0.851(95%CI:0.697-0.999)in the testing set.Conclusions:There are significant correlations between radiomics features extracted from MRI T2WI images of parotids and late radiation-induced xerostomia in NPC patients.Among the radiomics features,the changes in cPG features pre-RT and post-RT have higher accuracy in predicting late radiation-induced xerostomia.
文摘Objective: To assess the relative standardization of acupuncture protocols for radiation-induced xerostomia. Methods: A literature search was carried out up to November 10, 2012 in the databases PubMed/ MEDLINE, EMBASE and China National Knowledge Infrastruction with the terms: radiation-induced xerostomia, acupuncture, acupuncture treatment, and acupuncture therapy. Five ancient Chinese classic acupuncture works were also reviewed with the keywords "dry mouth, thirst, dry tongue, dry eyes and dry lips" to search the effective acupuncture points for dry mouth-associated symptoms in ancient China. Results: Twenty-two full-text articles relevant to acupuncture treatment for radiation-induced xerostomia were included and a total of 48 acupuncture points were searched in the 5 ancient Chinese classic acupuncture works, in which the most commonly used points were Chengjiang (CV24), Shuigou (GV 26), Duiduan (GV 27), Jinjin (EX-HN 12), and Yuye (EX-HN 13) on head and neck, Sanjian (LI 3), Shangyang (LI 1), Shaoshang (LU 11), Shaoze (SI 1), Xialian (LI 8) on hand, Fuliu (KI 7), Dazhong (KI 4), Zuqiaoyin (GB 44), Taichong (LR 3), Zhaohai (KI 6) on foot, Burong (ST 19), Zhangmen (LR 13), Tiantu (CV 22), Qimen (LR 14) on abdomen, Feishu (BL 13), Danshu (BL 19), Xiaochaogshu (BL 27), Ganshu (BL 18) on back, Shenmen (TF 4), Shen (CO10, Kidney), Yidan (CO11, Pancreas) and Pi (CO13, Spleen) on ear. Conclusion: There were considerable heterogeneities in the current acupuncture treatment protocols for radiation-induced xerostomia. Based on the results of the review and the personal perspectives, the authors provide a recommendation for manual acupuncture protocols in treating radiationinduced xerostomia patients with head and neck cancer.
文摘BACKGROUND: Xerostomia is one of the most common side effects of radiation therapy among patients with head and neck cancers (HNC). However, conventional medicine lacks an effective treatment for radiation-induced xerostomia. OBJECTIVE: Synthesizing the traditional use ofAIcea digitata and Malva sylvestris with their known beneficial effects from recent studies, we evaluated the efficacy of the herbs in the quality of life (QOL) of HNC patients with radiation-induced xerostomia. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This study is a randomized, double-arm, open-label active-controlled clinical trial. We evaluated the effect ofA. digitata and M. sy/vestris on QOL of HNC patients with radiation-induced xerostomia compared with Hypozalix (artificial saliva). Patients were enrolled from the Imam Hossein Hospital's oncology clinic in Shahid Beheshti University of Medica Sciences. Tehran, Iran. MAIN OUTCOME MEASURES: Primary outcome measures in this trial were changes in patients' QOL assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Head and Neck Module (EORTC QLQ-H&N 35). RESULTS: Between-group analysis showed that the intervention group patients obtained significantly lower (better) total EORTC QLQ-H&N 35 scores as compared to the control group at the end of the intervention period (P = 0.007). Mean scores of dry mouth of EORTC QLQ-H&N 35 was also significantly lower (better) in the intervention group as compared to the control group (P = 0.017).