Percorrer por autor "Guarino, Francesco"
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- Treatment of radio-induced xerostomia in head and neck cancer patients: a systematic reviewPublication . Guarino, Francesco; Oliveira, Filipa Pinto deIntroduction: Xerostomia is a debilitating condition characterized by reduced or absent saliva production. This issue is particularly common in patients undergoing radiotherapy for head and neck cancers, as the salivary glands are often affected by radiotherapy treatments. Patients suffering from xerostomia may experience difficulties in swallowing, speaking, and sleeping. Furthermore, the lack of saliva increases the risk of oral infections, dental caries, and taste disorders, negatively impacting their quality of life. Objective: This systematic literature review aims to examine the therapies currently available for managing radiotherapy-induced xerostomia, analyzing their effectiveness and impact on patients' quality of life. The question this thesis aims to answer is: “What are the treatment options available for patients treated with radiotherapy for head and neck cancer?”. Methodology: To structure this investigation, the PICO model was used. Several electronic databases will be utilized, including PubMed, B-On, and the Cochrane Library. Articles will be searched using the following keywords: "Radiotherapy," "Oral cancer," "xerostomia”, “Treatment”, while excluding "Chemotherapy." These terms will be combined in various ways using the Boolean operators "OR," "AND," and "NOT." Our inclusion criteria were human clinical trials. The exclusion criteria were: systematic reviews, meta-analyses, studies in animals, and articles in languages other than English. The systematic review was carried out in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Results: Pilocarpine, which stimulates saliva production, remains one of the most well established treatments. Acupuncture is a valid alternative when available, especially for patients who prefer non-pharmacological therapies. Sodium-hyaluronate mouthwash is useful as a short-term supportive measure. Low-level laser therapy, stem-cell injections, the vitamin C/E complex, and experimental topical sprays show promising results but require larger randomized trials before their comparative effectiveness can be defined. No study has reported serious treatment-related adverse events. The side effects noted (sweating with pilocarpine, mild swelling after stem-cell injections, and small bruises or hematomas from acupuncture) were rare. Conclusions: RIX (Radiotherapy-Induced Xerostomia) remains a significant clinical issue that compromises the quality of life of head and neck cancer (HNC) survivors. Future research should focus on rigorous, large-scale trials with prolonged follow-up and standardized outcomes to establish the definitive effectiveness of these interventions and guide clinical practice in managing RIX.