Does hyperbaric oxygen therapy have the potential to improve salivary gland function in irradiated head and neck cancer patients?

Tiffany Hadley,Jeffery Anderson,Marcy Wells Rogers,Cassaundra Song,Lauren Wells,Brian Novy,Takkin Lo,Michael Terry,Jennifer Lehnhardt

doi:10.1186/2045-9912-3-15

Abstract

Following radiotherapy, many patients with osteoradionecrosis suffer from xerostomia, thereby decreasing their quality of life. Patients can develop problems with speech, eating, increased dental caries, dysphagia, fractured dentition, chronic refractory osteomyelitis and osteoradionecrosis. Symptoms associated with salivary gland dysfunction can be severe enough that patients terminate the course of their radiotherapy prematurely due to the decrease in their quality of life. Currently, the only treatments available to patients are palliative. A definitive treatment has yet to be discovered. Head and neck cancers, which comprise 5% of overall cancer treatments, rank 8th most expensive to treat in the United States today. Hyperbaric oxygen is being considered for the therapy of radiated salivary glands because it has been shown to stimulate capillary angiogenesis and fibroplasia in radiation treated tissues. It has been hypothesized that salivary acinar cells undergo apoptosis following radiation therapy. The purpose of this paper is to discuss the mechanisms of salivary gland injury and evaluate whether hyperbaric oxygen therapy improves salivary gland function in patients who develop xerostomia and osteoradionecrosis following head and neck radiation.

Highlights

Head and neck cancers account for approximately 5% of the overall cancers treated in the United States and ranked the 8th most expensive cancer in the United States today [1]
A subsequent study was conducted by a group of investigators to evaluate the effect Hyperbaric oxygen therapy (HBOT) has on salivary flow rate, pH, and salivary bacteria involved in head and neck irradiated patients. These results showed that HBOT may be able to decrease caries risk due to its beneficial effects on pH, bacterial load in the oral cavity, and salivary flow [14]
Our study is anticipated to show the efficacy of HBOT in reducing xerostomia for head and neck cancer patients who have undergone radiation

Summary

Introduction

Head and neck cancers account for approximately 5% of the overall cancers treated in the United States and ranked the 8th most expensive cancer in the United States today [1]. There are five primary sites that make up this group of cancers: larynx, pharynx, oral cavity, salivary glands, and paranasal sinuses [2]. Of these patients who undergo standard head and neck radiotherapy, significant damage to the salivary glands can occur and result in hyposalivation and xerostomia, which is the condition of dry mouth caused by decreased salivation. Hyposalivation is among the most widely recognized causes of dental caries, and oral discomfort, which includes oral sores, changes in taste, difficulty chewing, swallowing, and difficulty with speech [3] This condition place patients at risk for dental caries and tooth decay because saliva normally bathes the oral cavity and acts as a clearing agent [4]. A more permanent and preventive therapy is yet to be discovered to improve salivary gland function in these patients

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