[abstract] HYPERBARIC OXYGEN THERAPY IN THE TREATMENT OF RADIATION-INDUCED XEROSTOMIA: A PILOT STUDY

Abstract

Introduction: The treatment of head and neck cancer with external beam irradiation is highly effective as an adjuvant to surgery or as primary therapy. An unfortunate side effect of radiotherapy is the development of salivary gland dysfunction and xerostomia, both closely linked to more significant sequelae of radiation therapy such as osteoradionecrosis of the mandible. This pilot study quantifies the effects of HBO2 on saliva flow rates, patient comfort, and overall quality of life. Materials and Methods: Patients referred for HBO2 therapy with a significant degree of xerostomia were asked to participate in this study. The primary endpoint was defined as millimeters of change in pre- and post-HBO2 subjective measurements of oral dryness using a 100-mm visual analog scale. Results: A total of 23 patients were enrolled in the study, but only 17 completed the entire protocol. For 9 (of 17) patients with both control and baseline measurements, pre-HBO2 mean change in dryness was -1 mm (95percent CI: -15 to +14). Based on these data, changes greater than 15 mm were considered to be clinically significant. After completing all HBO2 sessions (n=17; mean, 34 sessions), 52.9percent (95percent CI: 27.7percent to 78.1percent) had improved oral dryness greater than 15 mm, indicating HBO2 had a measurable effect on xerostomia. Summary/Conclusions: We have shown that patients report increased salivary function after HBO2. The fact that patients received dental extractions should not have any affect on xerostomia, but could potentially be a confounding factor. An additional limitation is that patients received variable lengths of therapy based on their original diagnosis. Further research is needed to determine the optimal length of therapy and which factors are most predictive of improvement in xerostomia using HBO2. xerostomia, radiation injury, hyperbaric oxygen, salivary flow, head and neck cancer