The influence of xerostomia after radiotherapy on quality of life

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Abstract
Xerostomia is a common complication of radiotherapy for head and neck cancer because irreparable damage is caused to the salivary glands if they are included in the radiation fields. The aim of the study was to evaluate the degree of xerostomia in survivors of head and neck cancer and to determine its impact on quality of life. A xerostomia questionnaire consisting of three parts (xerostomia score, quality of life survey, and visual analogue scale) was completed by 75 head and neck cancer patients, more than 6 months after radiotherapy and without evidence of disease. The majority of patients (93%) suffered from a dry mouth, and 65% had moderate to severe xerostomia (grade 2 to 3). Both dysphagia (65%) and taste loss (63%) were common, although oral pain was less frequent (33%). The emotional impact of xerostomia was significant, causing worry (64%), tension (61%), or feelings of depression (44%). Furthermore, patients reported problems with talking to (60%) or eating with (54%) other people and to feel restricted in amount and type of food (65%). Quality of life was influenced by T classification, clinical stage, a higher radiation dose or the use of concomitant chemotherapy, but was independent of the interval since the end of radiotherapy. Xerostomia after radiotherapy for head and neck cancer is extremely common and significantly affects quality of life. No recuperation is seen over time, and the use of concomitant chemotherapy significantly increases the oral complications of radiation. These results warrant the continuing efforts put into the development of salivary gland-sparing radiotherapy techniques and effective treatments of radiation-induced xerostomia.