Avaliação da xerostomia e hipossalivação em pacientes com câncer de cabeça e pescoço submetidos à tratamento radioterapeutico: um estudo prospectivo

Abstract

Radiotherapy is a therapeutic intervention widely used in the treatment of malignant neoplasms. However, irradiation of the salivary glands, frequently included in the treatment field, can result in hyposalivation, characterized by decreased salivary production. The study was prospective, with patients undergoing radiotherapy for head and neck cancer, which aimed to evaluate the amount of unstimulated saliva before, during and after antineoplastic treatment (radiotherapy) and associate it with clinical parameters (harmful habits and radiation dose). The sample included 18 patients with head and neck cancer, who had their saliva collected before radiotherapy treatment (T1), during (T2) and after the end of treatment (T3), 83.3% male and 16.7% female, with an average age of 63.83 years. At T1, the total amount of saliva was significantly higher among smokers compared to non-smokers, with a statistically significant difference between non-smokers and former smokers (p=0.019). At moments T1 and T2, the amount of saliva from smokers was significantly higher compared to ex-smokers (p<0.001 and p=0.01, respectively). Statistical analysis indicated significant variation between the moments evaluated, with a difference in the means at T1 (p<0.05) between the non-smokers, smokers and ex-smokers groups. The most severe hyposalivation was recorded when the mean radiation dose reached 3000 cGy. The mean and standard deviation of the total amount of unstimulated saliva counting all groups (smokers, non-smokers and ex-smokers) were: T1 = 3.36 ± 2.22 ml, T2 = 1.93 ± 2.35 ml and T3 = 1.73 ± 1.95 ml. Comparison of these saliva values at the three moments, using the Friedman test, revealed a significant difference (p=0.006). After Bonferroni adjustment, the difference between T1 and T2 was statistically significant (p=0.0014). In view of these findings, the participation of the dental surgeon in oncological treatment becomes essential in order to improve the quality of life of patients. In view of these findings, the participation of the dental surgeon in the oncology team is essential for the treatment of severe hyposalivation in order to improve the patient's quality of life.