Abstract
To verify the acute effect of electrostimulation on the salivary flow of patients with hyposalivation. Uncontrolled clinical trial evaluating 15 patients with hyposalivation induced by radiotherapy (RT) used for head and neck cancer treatment. Mean age of the patients was 56.8 ± 6.46 years. Males outnumbered females (73%). Transcutaneous Electrical Nerve Stimulation (TENS) was adjusted with 50Hz of frequency and 250μs of pulse width. Intensity was adjusted over a 20-minute period according to maximum tolerance. The electrodes were attached bilaterally on the region of the salivary glands. Evaluation of the salivary flow was performed through sialometry before and immediately after application of TENS. The most prevalent region for RT was the oropharynx (80.0% of cases). The mean dose used in RT was 64.6 ± 7.27 Gy. After TENS, salivary flow increased significantly (p = 0.0051) from 0.05 (0.00; 0.40) mL/min to 0.10 (0.07: 0.40) mL/min. The response to TENS was directly correlated with the intensity of the tolerated electric current (r = 0.553; p = 0.032) and the dose used in RT (r = -0.514; p = 0.050). TENS was able to increase the salivary flow rate of patients with RT-induced hyposalivation.
Highlights
Head and neck cancer has an approximate incidence of 900,000 cases per year worldwide
After the end of RT, all patients included in this study who had hyposalivation had a change in the quantity of saliva while 12 of them (80%) had a change in viscosity
The results of this study showed that Transcutaneous Electrical Nerve Stimulation (TENS) significantly increased the salivary flow of patients with head and neck cancer and RT-induced hyposalivation
Summary
Head and neck cancer has an approximate incidence of 900,000 cases per year worldwide. In Brazil, according to estimates, 38,000 cases are expected in the biennium 2016-2017(1), it is considered as one of the most prevalent types of cancer[2]. There are different therapeutic options depending on the anatomical location of the tumor, histological type, extent of primary lesion, cervical lymphadenopathy, morbidity which is expected and associated with each modality of treatment, clinical condition and patient option. RT for head and neck tumors involves doses between 50-70 Gy, and adverse effects depend on the method in use, number of doses, intensity of exposure and individual characteristics. The main changes caused by the treatment are dysphagia, dysgeusia, mucositis, odynophagia, trismus, radiodermatitis and hyposalivation[5]
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