Radiation Induced Xerostomia: Current Concepts and Future Trends

  • Manu Krishnan Department of Dental Research and Implantology, Institute of Nuclear Medicine and Allied Sciences, Delhi
  • Satish R Iyer Armed Forces Dental Clinic, Delhi
  • Kanti Lal Chakraborti Dept of Radiologic Imaging, Institute of Nuclear Medicine and Allied Sciences, Delhi
  • Saraswathy Seema School of Medicine and Paramedical Health Sciences, Guru Gobind Singh Indraprastha University, Delhi
  • Tarun Sekhri Division of Health, Endocrinology and Thyroid Research,Institute of Nuclear Medicine and Allied Sciences, Delhi
Keywords: Radiation induced xerostomia, Quality of life, Radioprotectors, Radiation countermeasures

Abstract

Radiation induced xerostomia is a persistent clinical presentation that affects the quality of life in head and neck cancer patients even with the best of the intensity modulated radiotherapy protocols. Comprehensive review of the anatomic, histologic, developmental and neuronal entities of salivary glands from a regenerative perspective, ensuing radiation is taken. It also evaluates the systemic and glandular radiation responses that form the early and late clinical changes. From these, the article submits probable strategies; based on the current knowledge and future challenges involved, in reversing radiation induced xerostomia. Further, it elaborates on the status of radioprotectors and mitigators including the recently reported biologic and chemical derivatives and proposes the rationale of using combination radioprotector therapy in radiation injuries. A brief of palliative regimes, alternate treatment modes and technologic advancements in radiotherapy are also explained. Salivary gland histologic components, which need to be protected in the emerging radiotherapy protocols and can be targeted in different salivary gland regeneration therapies is highlighted. The paper contributes to an improved understanding in radiation induced xerostomia and deliberates on novel mechanisms towards enhancing quality of life in head and neck cancer radiotherapy patients.

Author Biographies

Manu Krishnan, Department of Dental Research and Implantology, Institute of Nuclear Medicine and Allied Sciences, Delhi

Lt Col Manu Krishnan did his graduation from Government Dental College, Thiruvananthapuram, Kerala University, in 1998 and post graduation from AFMC Pune, Mumbai University, in 2005. He is a Classified Specialist in Orthodontics, who is presently heading the Department of Dental Research and Implantology, at INMAS, Delhi. His research areas include: Oral cancer and Radiation Biosciences.

Satish R Iyer, Armed Forces Dental Clinic, Delhi

Brig Satish R Iyer is a graduate of Dr R Ahmed Dental College and Hospital, in 1985 and post graduate in Dental Sciences from Bombay University, in 1995. He is a consultant in Prosthodontics, who is presently the commandant of Armed Forces Dental Clinic (AFDC) in Delhi. He has extensive clinical, teaching and research experience in dental sciences especially in rehabilitating head and neck cancer patients post - surgical and radiation treatment using maxillofacial prostheses. 

Kanti Lal Chakraborti, Dept of Radiologic Imaging, Institute of Nuclear Medicine and Allied Sciences, Delhi

Dr. Kanti Lal Chakraborti did MBBS from University of Kerala, in 1984, MD Radio Diagnosis from University of Surashtra, in 1990, Post Doctoral Certificate Course from Sree Chitra Tirunal Institute for Medical Science and Technology, Kerala 1991 and Cardiovascular and Neuro Radiology Medical Impedence Technology Course Yaroslavl State Medical University in 2009. Presently working as Scientist ‘F’ and Head, Dept of Radiologic Imaging at INMAS, Delhi. His area of specialization is breast cancer imaging.

Saraswathy Seema, School of Medicine and Paramedical Health Sciences, Guru Gobind Singh Indraprastha University, Delhi

Dr Seema S did her MSc from Mahatma Gandhi University, in 2005, MPhil from Central University of Punjab, Bathinda, in 2012 and PhD in Biochemistry from School of Medicine and Paramedical Health Sciences, Guru Gobind Singh Indraprastha University, Delhi, in 2017. She is an academician in clinical biochemistry.

Tarun Sekhri, Division of Health, Endocrinology and Thyroid Research,Institute of Nuclear Medicine and Allied Sciences, Delhi

Dr Tarun Sekhri, did his MBBS from University College of Medical Sciences, in 1982, DRM in 1986, DTCD from V Patel Chest Institute all from Delhi University and MD (Medicine), LLRM Medical College, Meerut University. Currently working as Scientist G and Addl Director and is presently heading the Division of Health, Endocrinology and Thyroid Research, of INMAS, Delhi. He carries clinical, academic and research experience over 25 years in Thyroid care, endocrinology and radiation biosciences. 

Published
2017-08-03
How to Cite
Krishnan, M., Iyer, S., Chakraborti, K., Seema, S., & Sekhri, T. (2017). Radiation Induced Xerostomia: Current Concepts and Future Trends. Defence Life Science Journal, 2(3), 256-263. https://doi.org/10.14429/dlsj.2.11669