Clinical evaluation of BIOXTRA in relieving signs and symptoms of dry mouth after head and neck radiotherapy of cancer patients at Seyed-al-Shohada Hospital, Isfahan, Iran

Gookizadeh, Abbas; Emami, Hamid; Najafizadeh, Nadia; Roayaei, Mahnaz

Clinical evaluation of BIOXTRA in relieving signs and symptoms of dry mouth after head and neck radiotherapy of cancer patients at Seyed-al-Shohada Hospital, Isfahan, Iran

Authors

Department of Radiation Oncology, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Radiotherapy of head and neck cancers causes acute and chronic xerostomia and acute mucositis. Xerostomia increases risk of radiation caries and affects on oral comfort, fit of prostheses, speech, swallowing, and the growth of caries-producing organisms. Salivary flow rate can be measured by asking patients some questions. There are different types of commercial synthetic saliva such as BIOXTRA, but until now, no one can effectively relieve xerostomia. We tried to design a clinical research on BIOXTRA efficacy for treating xerostomia.
Materials and Methods: In this research, 58 patients with head and neck cancer (except salivary gland cancers) treated in Seyed-al-Shohada Hospital. The patients received at least 40-50 GY; and after 2 months of compilation treatment, they were evaluated by asking about having xerostomia. Before and after treatment with the BIOXTRA, the PH of the oral cavity, candida albicans, and lactobacillus counts measured and documented in laboratory. We used BIOXTRA for 2 weeks, 3 times daily, and then re-evaluated patients with some questions.
Results: The counts of candida albicans and lactobacilli statistically significant decreased.
Conclusion: Xerostomia for most patients improved clinically during the day and night while PH of the oral cavity increased.

Keywords

References

1.	Tschiesner U, Rogers SN, Harréus U, Berghaus A, Cieza A. Content comparison of quality of life questionnaires used in head and neck cancer based on the international classification of functioning, disability and health: A systematic review. Eur Arch Otorhinolaryngol 2008;265:627-37.
2.	Perez CA. Brady's. Principles and practice of radiation oncology. 5 ^th ed. Philadelphia: Lippincott Williams and Wilkins Company; 2008.p. 2-137.
3.	Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ. Cancer statistics, 2003. CA Cancer J Clin 2003;53:5-26.
4.	Ghezzi EM, Lange LA, Ship JA. Determination of variation of stimulated salivary flow rates. J Dent Res 2000;79:1874-8.
5.	Navazesh M, Christensen C, Brightman V. Clinical criteria for the diagnosis of salivary gland hypofunction. J Dent Res 1992;71:1363-9.
6.	Sreebny LM, Valdini A, Yu A. Xerostomia, part II: Relationship to nonoral symptoms, drugs, and diseases. Oral Surg Oral Med Oral Pathol 1989;68:419-27.
7.	Fox PC, Busch KA, Baum BJ. Subjective reports of xerostomia and objective measures of salivary gland performance. J Am Dent Assoc 2000;115:581-4.
8.	International Dental Federation. Working Group 10 of the Commission on Oral Health, Research and Epidemiology (CORE). Saliva: Its role in health and disease. Int Dent J 1992;42(4 supplement 2):287-304.
9.	Loesche WJ, Bromberg J, Terpenning MS, Bretz WA, Dominguez BL, Grossman NS, et al. Xerostomia, xerogenic medications and food avoidances in selected geriatric groups. J Am Geriatr Soc 1995;43:401-7.
10.	Niedermeier WH, Kramer R. Salivary secretion and denture retention. J Prosthet Dent 2002;67:211-6.
11.	Samaranayake LP. Host factors and oral candidosis. In: Samaranayake LP, MacFarlane TW, editors. Oral candidosis. London: Wright; 1990. p. 66-103.
12.	Braam PM, Roesink JM, Moerland MA, Raaijmakers CP, Schipper M, Terhaard CH. Long-term parotid gland function after radiotherapy. Int J Radiat Oncol Biol Phys 2005;62:659-64.
13.	Rhodus NL, Bereuter J. Clinical evaluation of a commercially available oral moisturizer in relieving signs and symptoms of xerostomia in postirradiation head and neck cancer patients and patients with Sjögren's syndrome. J Otolaryngol 2000;29:28-34.
14.	Dirix P, Nuyts S, Vander Poorten V, Delaere P, Van den Bogaert W. Efficacy of Bioxtra dry mouth care system in the treatment of radiotherapy induced xerostomia rostomia. Support Care Cancer 2007;15:1429-36. Epub 2007 Jan 18. Available from: http://www.springerlink.com /content/ k8781784w215v440
15.	Shahdad SA, Taylor C, Barclay SC, Steen IN, Preshaw PM. A double blind, crossover study of Biotene Oralbalance & Bioxtra systems as salivary substitutes in patient with post-raditherapy xerostomia. Eur J Cancer Care (Engl) 2005;14:319-26.

Advanced Biomedical Research