NEW YORK (Reuters Health) - In patients with head and neck cancer, xerostomia can be prevented by transfer of a submandibular gland to the submental space before radiation therapy is administered, Canadian investigators report.
Xerostomia is a “permanent and devastating” consequence of head and neck irradiation, affecting most aspects of patients’ lives, Dr. Hadi Seikaly of the University of Alberta in Edmonton and associates note. The “Siekaly-Jha procedure” (SJP) was developed as a means of preserving and protecting a single submandibular gland and maintaining salivary function.
In the August issue of the Archives of Otolaryngology Head and Neck Surgery, the investigators report long-term results of a phase II clinical trial initiated in 1999 to evaluate the SJP in patients with head and neck cancer. Included were 38 patients who have been followed for at least 24 months.
The SJP procedure was performed when patients underwent primary surgery. Gland preservation was not attempted in 12 patients because of the presence of disease on pathologic examination in the lymph nodes on the side of the transfer.
Salivary flow was preserved in the 26 patients who underwent the procedure, with significant differences between the two groups apparent even before radiotherapy was completed. There were also significant differences between the groups in patients’ responses on saliva questionnaires beginning at 2 months after treatment was completed.
At the 2-year mark, 83% of the surviving patients who underwent the SJP reported a normal amount of saliva, while none of those for whom the SJP could not be performed had normal saliva levels.
There was no disease recurrence on the side of the transferred gland or in the submental space, the authors report. The rate and site of recurrence, as well as survival rate and cause of death, did not differ between groups.
The procedure is safe, does not require special radiation equipment or surgical skills, and does not alter the standard radiation prescription, Dr. Seikaly’s group concludes. “The main disadvantage of the SJP is that it is contraindicated in oral cavity malignancies.”
Source: Arch Otolaryngol Head Neck Surg 2004;130:956-961. [ Google search on this article ]
MeSH Headings:Head and Neck Neoplasms: Neoplasms: Neoplasms by Site: surgery: therapy: DiseasesCopyright © 2002 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
