Abstract

Head and neck radiotherapy causes quantitative and qualitative changes in saliva. The objective of this case-control study was to evaluate the salivary biomarkers associated with bone remodeling and tissue repair in patients submitted to radiotherapy for head and neck cancer treatment, compared with non-irradiated individuals. Total unstimulated saliva was collected for ELISA assay analysis of receptor activator for nuclear factor κ B (RANK) and its ligand (RANK-L), osteoprotegerin, matrix metalloproteinase-9/ tissue inhibitor of metalloproteinase-2, vascular endothelial growth factor, and epidermal growth factor. Statistics were performed, and revealed that salivary RANK (p = 0.0304), RANK-L (p = 0.0005), matrix metalloproteinase-9/ tissue inhibitor of metalloproteinase-2 (p = 0.0067), vascular endothelial growth factor (p = 0.0060), and epidermal growth factor (p < 0.0001) were reduced in patients, compared with the control group. Osteoprotegerin did not differ between the groups (p = 0.3765). Salivary biomarkers did not differ according to radiotherapy completion time (p > 0.05). In conclusion, the lower output of the salivary molecules - essential for bone remodeling and tissue repair - may disrupt tissue homeostasis and play a role in the pathogenesis of the radiotherapy-induced deleterious effects in the oral cavity.

Highlights

  • Radiotherapy (RT) is frequently applied to treat head and neck cancer patients, in association with either surgery or chemotherapy.[1]

  • The main goal of the current study was to assess the salivary biomarkers related to bone remodeling and tissue repair, namely RANK, RANK-L, OPG, MMP-9/ Tissue inhibitor of metalloproteinases 2 (TIMP-2), vascular endothelial growth factor (VEGF), and Epidermal growth factor (EGF), in patients submitted to head and neck RT, compared with non-irradiated individuals

  • The results of the current study showed a reduction in salivary flow in the irradiated patients, compared with the controls

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Summary

Introduction

Radiotherapy (RT) is frequently applied to treat head and neck cancer patients, in association with either surgery or chemotherapy.[1].

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