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Somay E, Topkan E, Selek U, Pehlivan B. Comment on Kittichet et al. (doi: 10.1111/odi.14905). Oral Dis 2024. [PMID: 39039761 DOI: 10.1111/odi.15089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 07/16/2024] [Indexed: 07/24/2024]
Affiliation(s)
- Efsun Somay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | - Erkan Topkan
- Department of Radiation Oncology, Faculty of Medicine, Baskent University, Adana, Turkey
| | - Ugur Selek
- Department of Radiation Oncology, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Berrin Pehlivan
- Department of Radiation Oncology, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey
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Anuja AR, Anoop R, Mohanan A, Ramesh NV. Jasminum grandiflorum oral gel as an add-on to standard of care in radiation induced grade 2 oral mucositis - an open label pilot clinical trial. J Ayurveda Integr Med 2024; 15:100925. [PMID: 39003915 PMCID: PMC11299567 DOI: 10.1016/j.jaim.2024.100925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 03/06/2024] [Accepted: 03/21/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Radiation-induced oral mucositis is one of the most critical dose-limiting toxicities associated with radiation therapy for oral cancer which can result in treatment interruption and compromise the quality of the life of cancer patients. Jati (Jasminum grandiflorum) is used in Ayurveda to treat oral conditions like stomatitis and mouth ulcers. OBJECTIVE To test the feasibility of Jati oral gel as an add on therapy in grade 2 radiation-induced oral mucositis. MATERIALS AND METHODS A prospective, open-label, non-randomised pilot trial was conducted on 20 patients with grade 2 radiation-induced oral mucositis at a tertiary cancer hospital. The control group received sodium bicarbonate mouthwash 4-5 times daily as the standard of care, while the intervention arm also received Jati oral gel twice daily. We used the ImageJ software for objective assessment and the Visual Analogue Scale for subjective pain assessment. The study was continued for 15 days or until the mucositis progressed to grade 3 or resolved to grade 1. RESULT There was a significant reduction in the mean pain score and mean area of mucositis in the intervention group compared to the control group. CONCLUSION Jati oral gel is a suitable medicament as an add-on therapy in managing grade 2 radiation-induced oral mucositis.
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Affiliation(s)
- A R Anuja
- Department of Rasashastra and Bhaishajya Kalpana (Pharmaceuticals), Amrita School of Ayurveda, Amritapuri, Amrita Vishwa Vidyapeetham, India
| | - R Anoop
- Department of Radiation Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Arun Mohanan
- Department of Rasashastra and Bhaishajya Kalpana (Pharmaceuticals), Amrita School of Ayurveda, Amritapuri, Amrita Vishwa Vidyapeetham, India
| | - N V Ramesh
- Department of Rasashastra and Bhaishajya Kalpana (Pharmaceuticals), Amrita School of Ayurveda, Amritapuri, Amrita Vishwa Vidyapeetham, India.
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Tanaka J, Miura A, Shimamura Y, Hwang Y, Shimizu D, Kondo Y, Sawada A, Sarmah H, Ninish Z, Mishima K, Mori M. Generation of salivary glands derived from pluripotent stem cells via conditional blastocyst complementation. Cell Rep 2024; 43:114340. [PMID: 38865239 DOI: 10.1016/j.celrep.2024.114340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 04/25/2024] [Accepted: 05/23/2024] [Indexed: 06/14/2024] Open
Abstract
Whole salivary gland generation and transplantation offer potential therapies for salivary gland dysfunction. However, the specific lineage required to engineer complete salivary glands has remained elusive. In this study, we identify the Foxa2 lineage as a critical lineage for salivary gland development through conditional blastocyst complementation (CBC). Foxa2 lineage marking begins at the boundary between the endodermal and ectodermal regions of the oral epithelium before the formation of the primordial salivary gland, thereby labeling the entire gland. Ablation of Fgfr2 within the Foxa2 lineage in mice leads to salivary gland agenesis. We reversed this phenotype by injecting donor pluripotent stem cells into the mouse blastocysts, resulting in mice that survived to adulthood with salivary glands of normal size, comparable to those of their littermate controls. These findings demonstrate that CBC-based salivary gland regeneration serves as a foundational experimental approach for future advanced cell-based therapies.
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Affiliation(s)
- Junichi Tanaka
- Columbia Center for Human Development and Division of Pulmonary, Allergy, Critical Care, Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA; Division of Pathology, Department of Oral Diagnostic Sciences, Showa University School of Dentistry, Tokyo 142-8555, Japan.
| | - Akihiro Miura
- Columbia Center for Human Development and Division of Pulmonary, Allergy, Critical Care, Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA
| | - Yuko Shimamura
- Columbia Center for Human Development and Division of Pulmonary, Allergy, Critical Care, Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA
| | - Youngmin Hwang
- Columbia Center for Human Development and Division of Pulmonary, Allergy, Critical Care, Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA
| | - Dai Shimizu
- Columbia Center for Human Development and Division of Pulmonary, Allergy, Critical Care, Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA
| | - Yuri Kondo
- Columbia Center for Human Development and Division of Pulmonary, Allergy, Critical Care, Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA
| | - Anri Sawada
- Columbia Center for Human Development and Division of Pulmonary, Allergy, Critical Care, Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA
| | - Hemanta Sarmah
- Columbia Stem Cell Initiative, Stem Cell Core, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Zurab Ninish
- Columbia Center for Human Development and Division of Pulmonary, Allergy, Critical Care, Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA
| | - Kenji Mishima
- Division of Pathology, Department of Oral Diagnostic Sciences, Showa University School of Dentistry, Tokyo 142-8555, Japan
| | - Munemasa Mori
- Columbia Center for Human Development and Division of Pulmonary, Allergy, Critical Care, Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA.
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Milgrom SA, van Luijk P, Pino R, Ronckers CM, Kremer LC, Gidley PW, Grosshans DR, Laskar S, Okcu MF, Constine LS, Paulino AC. Salivary and Dental Complications in Childhood Cancer Survivors Treated With Radiation Therapy to the Head and Neck: A PENTEC Comprehensive Review. Int J Radiat Oncol Biol Phys 2024; 119:467-481. [PMID: 34074567 DOI: 10.1016/j.ijrobp.2021.04.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/14/2021] [Accepted: 04/21/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Radiation therapy (RT) to the head and neck (H&N) region is critical in the management of various pediatric malignancies; however, it may result in late toxicity. This comprehensive review from the Pediatric Normal Tissue Effects in the Clinic (PENTEC) initiative focused on salivary dysfunction and dental abnormalities in survivors who received RT to the H&N region as children. MATERIALS & METHODS This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. RESULTS Of the 2,164 articles identified through a literature search, 40 were included in a qualitative synthesis and 3 were included in a quantitative synthesis. The dose-toxicity data regarding salivary function demonstrate that a mean parotid dose of 35 to 40 Gy is associated with a risk of acute and chronic grade ≥2 xerostomia of approximately 32% and 13% to 32%, respectively, in patients treated with chemo-radiation therapy. This risk increases with parotid dose; however, rates of xerostomia after lower dose exposure have not been reported. Dental developmental abnormalities are common after RT to the oral cavity. Risk factors include higher radiation dose to the developing teeth and younger age at RT. CONCLUSIONS This PENTEC task force considers adoption of salivary gland dose constraints from the adult experience to be a reasonable strategy until more data specific to children become available; thus, we recommend limiting the parotid mean dose to ≤26 Gy. The minimum toxic dose for dental developmental abnormalities is unknown, suggesting that the dose to the teeth should be kept as low as possible particularly in younger patients, with special effort to keep doses <20 Gy in patients <4 years old.
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Affiliation(s)
- Sarah A Milgrom
- Department of Radiation Oncology, University of Colorado, Aurora, Colorado
| | - Peter van Luijk
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Ramiro Pino
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, Texas
| | - Cecile M Ronckers
- Princess Máxima Centrum for Pediatric Oncology, Utrecht, Netherlands; Institute of Biostatistics and Registry Research, Brandenburg Medical School-Theodor Fontane, Neuruppin, Germany
| | - Leontien C Kremer
- Institute of Biostatistics and Registry Research, Brandenburg Medical School-Theodor Fontane, Neuruppin, Germany; UMC Amsterdam, Location AMC, Department of Pediatrics, Amsterdam, Netherlands
| | - Paul W Gidley
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas
| | - David R Grosshans
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas
| | - Siddhartha Laskar
- Department of Radiation Oncgqtology, Tata Memorial Hospital, Mumbai, India
| | - M Fatih Okcu
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Louis S Constine
- Department of Radiation Oncology, University of Rochester, Rochester, New York
| | - Arnold C Paulino
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas.
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Mosannen Mozaffari P, Delavarian Z, Fekrazad R, Fani Pakdel A, Rashed Mohassel M, Taghi Shakeri M, Ghazi A. Evaluation of the Effect of Photobiomodulation on Radiation-Induced Xerostomia in Head and Neck Cancer Patients: A Randomized Clinical Trial. J Lasers Med Sci 2024; 15:e4. [PMID: 38655042 PMCID: PMC11033859 DOI: 10.34172/jlms.2024.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 12/16/2023] [Indexed: 04/26/2024]
Abstract
Introduction: Radiotherapy-induced xerostomia is an important side effect of head and neck cancer (HNC) treatment. Photobiomodulation (PBM) is one of the new emerging methods for preventing or reducing this problem. The aim of this study is to evaluate the effect of PBM on radiation-induced xerostomia in HNC patients. Methods: Thirty-seven patients with HNC who were referred for radiotherapy to Mashhad cancer center. In the case group, an infrared diode laser was used in contact mode on 16 points (covering minor and major salivary glands). The device emitted a wavelength of 810 nm and operated at the power of 200 mW and continuous wave mode. Each area was irradiated for 4 seconds in contact mode with gentle pressure, and the laser energy was 0.8 J with an energy density of 2.85 J/cm2 at the surface of the probe (spot size, 0.28 cm2 ). The total dose was 45.6 J/cm2. The power density was 714.2 w/cm2. In the control group, the sham laser device was used. Subjective xerostomia was evaluated through the LENT SOMA scale (LSS). Stimulated and unstimulated saliva was also assessed. Data were analyzed with SPSS ver22 statistical software. Results: The study included 26 men and 11 women with a mean age of 55.6±15.3 years. In the sixth week, the case group produced more stimulated saliva than the control group (P=0.006). They also had less subjective xerostomia than the control group in weeks four to six. Conclusion: In the present study, PBM had a preventive effect on stimulated saliva and subjective xerostomia and can be recommended as an adjunctive treatment. Further studies with a higher sample size and the use of a low-level laser in more sessions are needed for definitive comment.
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Affiliation(s)
- Pegah Mosannen Mozaffari
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Delavarian
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center, AJA University of Medical Sciences, Tehran, Iran
- International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research, Network (USERN), Tehran, Iran
| | - Azar Fani Pakdel
- Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mohammad Taghi Shakeri
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ala Ghazi
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Sample C, Rahmim A, Benard F, Wu J, Clark H. PSMA PET/CT as a predictive tool for subregional importance estimates in the parotid gland. Biomed Phys Eng Express 2024; 10:025020. [PMID: 38271732 DOI: 10.1088/2057-1976/ad229c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/25/2024] [Indexed: 01/27/2024]
Abstract
Objective. Xerostomia and radiation-induced salivary gland dysfunction remain a common side effect for head-and-neck radiotherapy patients, and attempts have been made to quantify the heterogeneity of the dose response within parotid glands. Prostate Specific Membrane Antigen (PSMA) ligands have demonstrated high uptake in salivary glands, which has been shown to correlate with gland functionality. Here we compare several models of parotid gland subregional relative importance with PSMA positron emission tomography (PET) uptake. We then develop a predictive model for Clarket al's relative importance estimates using PSMA PET and CT radiomic features, and demonstrate a methodology for predicting patient-specific importance deviations from the population.Approach. Intra-parotid gland uptake was compared with four regional importance models using 30 [18F]DCFPyL PSMA PET images. The correlation of uptake and importance was ascertained when numerous non-overlapping subregions were defined, while a paired t-test was used to compare binary region pairs. A radiomics-based predictive model of population importance was developed using a double cross-validation methodology. A model was then devised for supplementing population-level subregional importance estimates for each patient using patient-specific radiomic features.Main Results. Anticorrelative relationships were found to exist between PSMA PET uptake and four independent models of subregional parotid gland importance from the literature. Kernel Ridge Regression with principal component analysis feature selection performed best over test sets (Mean Absolute Error = 0.08), with gray level co-occurrence matrix (GLCM) features being particularly important. Deblurring PSMA PET images with neural blind deconvolution strengthened correlations and improved model performance.Significance. This study suggests that regions of relatively low PSMA PET uptake in parotid glands may exhibit relatively high dose-sensitivity. We've demonstrated the utility of PSMA PET radiomic features for predicting relative importance within subregions of parotid glands. PSMA PET appears to be a promising quantitative imaging modality for analyzing salivary gland functionality.
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Affiliation(s)
- Caleb Sample
- Department of Physics and Astronomy, Faculty of Science, University of British Columbia, Vancouver, BC, Canada
- Department of Medical Physics, BC Cancer, Surrey, BC, Canada
| | - Arman Rahmim
- Department of Physics and Astronomy, Faculty of Science, University of British Columbia, Vancouver, BC, Canada
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, Canada
| | - François Benard
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, Canada
- Department of Molecular Oncology, BC Cancer, Vancouver, BC, Canada
| | - Jonn Wu
- Department of Radiation Oncology, BC Cancer, Vancouver, BC, Canada
- Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Haley Clark
- Department of Physics and Astronomy, Faculty of Science, University of British Columbia, Vancouver, BC, Canada
- Department of Medical Physics, BC Cancer, Surrey, BC, Canada
- Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Zhou P, Zhou R, Yu YF, Rao MY, Wu SG. Xerostomia: An easily ignored symptom induced by induction chemotherapy in patients with nasopharyngeal carcinoma. Head Neck 2023; 45:3024-3032. [PMID: 37750446 DOI: 10.1002/hed.27529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 08/20/2023] [Accepted: 09/16/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND To investigate the prevalence and predictive factors of xerostomia during induction chemotherapy (IC) in patients with nasopharyngeal carcinoma (NPC). METHODS We prospectively enrolled NPC patients who received IC between October 2020 and October 2021. The Visual Analogue Scale (VAS) and Xerostomia Inventory (XI) were used to evaluate the condition of xerostomia. The volume of the submandibular gland (SMG) was also calculated before and after IC. RESULTS Fifty-two patients were enrolled in this study. Of these patients, 32.7% (n = 17) experienced xerostomia before IC. There were 32 (61.5%) patients suffered from xerostomia after IC, including 21 (40.4%) patients with newly diagnosed xerostomia after IC and 11 (21.1%) patients complained their xerostomia aggravated in those with xerostomia before IC. The median XI scores increased from 11 (standard deviation [SD], 2.930) to 18 (SD 3.995), 16 (SD 3.605), and 17 (SD 4.331) after the first, second, and third cycles of IC, respectively. The median score of VAS also increased from 0 to 4 during the following three cycles of IC. In those with IC-related xerostomia, the SMG volume after IC was significantly decreased compared with those without IC-related xerostomia (P = 0.001). The reduction of the SMG volume after IC was the independent risk factor for xerostomia (P = 0.002). CONCLUSION Approximately two-thirds of NPC patients suffered from IC-related xerostomia and patients with a reduction of SMG volume after IC had a higher risk of xerostomia.
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Affiliation(s)
- Ping Zhou
- Department of Radiation Oncology, Xiamen Cancer Center, Xiamen Key Laboratory of Radiation Oncology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Rui Zhou
- Department of Radiation Oncology, Xiamen Cancer Center, Xiamen Key Laboratory of Radiation Oncology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Yi-Feng Yu
- Department of Radiation Oncology, Xiamen Cancer Center, Xiamen Key Laboratory of Radiation Oncology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Ming-Yue Rao
- Department of Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - San-Gang Wu
- Department of Radiation Oncology, Xiamen Cancer Center, Xiamen Key Laboratory of Radiation Oncology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
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Tanaka J, Miura A, Shimamura Y, Hwang Y, Shimizu D, Kondo Y, Sawada A, Sarmah H, Ninish Z, Mishima K, Mori M. Generation of salivary glands derived from pluripotent stem cells via conditional blastocyst complementation. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.13.566845. [PMID: 38014349 PMCID: PMC10680620 DOI: 10.1101/2023.11.13.566845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Various patients suffer from dry mouth due to salivary gland dysfunction. Whole salivary gland generation and transplantation is a potential therapy to resolve this issue. However, the lineage permissible to design the entire salivary gland generation has been enigmatic. Here, we discovered Foxa2 as a lineage critical for generating a salivary gland via conditional blastocyst complementation (CBC). Foxa2 linage, but not Shh nor Pitx2, initiated to label between the boundary region of the endodermal and the ectodermal oral mucosa before primordial salivary gland formation, resulting in marking the entire salivary gland. The salivary gland was agenesis by depleting Fgfr2 under the Foxa2 lineage in the mice. We rescued this phenotype by injecting donor pluripotent stem cells into the mouse blastocysts. Those mice survived until adulthood with normal salivary glands compatible in size compared with littermate controls. These results indicated that CBC-based salivary gland generation is promising for next-generation cell-based therapy.
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Marinkovic M, Tran ON, Wang H, Abdul-Azees P, Dean DD, Chen XD, Yeh CK. Extracellular matrix turnover in salivary gland disorders and regenerative therapies: Obstacles and opportunities. J Oral Biol Craniofac Res 2023; 13:693-703. [PMID: 37719063 PMCID: PMC10502366 DOI: 10.1016/j.jobcr.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/28/2023] [Indexed: 09/19/2023] Open
Abstract
Salivary gland (SG) extracellular matrix (ECM) has a major influence on tissue development, homeostasis, and tissue regeneration after injury. During aging, disease, and physical insult, normal remodeling of the SG microenvironment (i.e. ECM) becomes dysregulated, leading to alterations in matrix composition which disrupt tissue architecture/structure, alter cell activity, and negatively impact gland function. Matrix metalloproteinases (MMPs) are a large and diverse family of metalloendopeptidases which play a major role in matrix degradation and are intimately involved in regulating development and cell function; dysregulation of these enzymes leads to the production of a fibrotic matrix. In the SG this altered fibrotic ECM (or cell microenvironment) negatively impacts normal cell function and the effectiveness of gene and stem cell therapies which serve as a foundation for many SG regenerative therapies. For this reason, prospective regenerative strategies should prioritize the maintenance and/or restoration of a healthy SG ECM. Mesenchymal stem cells (MSCs) have great potential for mitigating damage to the SG microenvironment by ameliorating inflammation, reducing fibrosis, and repairing the damaged milieu of extracellular regulatory cues, including the matrix. This review addresses our current understanding of the impact of aging and disease on the SG microenvironment and suggests critical deficiencies and opportunities in ECM-targeted therapeutic interventions.
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Affiliation(s)
- Milos Marinkovic
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229-3900, USA
- Research Service, South Texas Veterans Health Care System, San Antonio, TX, 78229-4404, USA
| | - Olivia N. Tran
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229-3900, USA
| | - Hanzhou Wang
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229-3900, USA
| | - Parveez Abdul-Azees
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229-3900, USA
- Research Service, South Texas Veterans Health Care System, San Antonio, TX, 78229-4404, USA
| | - David D. Dean
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229-3900, USA
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, TX, 78249, USA
| | - Xiao-Dong Chen
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229-3900, USA
- Research Service, South Texas Veterans Health Care System, San Antonio, TX, 78229-4404, USA
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, TX, 78249, USA
| | - Chih-Ko Yeh
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229-3900, USA
- Geriatric Research, Education and Clinical Center, South Texas Veterans Health Care System, San Antonio, TX, 78229-4404, USA
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Nagakubo D, Kaibori Y. Oral Microbiota: The Influences and Interactions of Saliva, IgA, and Dietary Factors in Health and Disease. Microorganisms 2023; 11:2307. [PMID: 37764151 PMCID: PMC10535076 DOI: 10.3390/microorganisms11092307] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/31/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
Recent advances in metagenomic analyses have made it easier to analyze microbiota. The microbiota, a symbiotic community of microorganisms including bacteria, archaea, fungi, and viruses within a specific environment in tissues such as the digestive tract and skin, has a complex relationship with the host. Recent studies have revealed that microbiota composition and balance particularly affect the health of the host and the onset of disease. Influences such as diet, food preferences, and sanitation play crucial roles in microbiota composition. The oral cavity is where the digestive tract directly communicates with the outside. Stable temperature and humidity provide optimal growth environments for many bacteria. However, the oral cavity is a unique environment that is susceptible to pH changes, salinity, food nutrients, and external pathogens. Recent studies have emphasized the importance of the oral microbiota, as changes in bacterial composition and balance could contribute to the development of systemic diseases. This review focuses on saliva, IgA, and fermented foods because they play critical roles in maintaining the oral bacterial environment by regulating its composition and balance. More attention should be paid to the oral microbiota and its regulatory factors in oral and systemic health.
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Affiliation(s)
- Daisuke Nagakubo
- Division of Health and Hygienic Sciences, Faculty of Pharmaceutical Sciences, Himeji Dokkyo University, 7-2-1 Kamiohno, Himeji 670-8524, Hyogo, Japan
| | - Yuichiro Kaibori
- Division of Health and Hygienic Sciences, Faculty of Pharmaceutical Sciences, Himeji Dokkyo University, 7-2-1 Kamiohno, Himeji 670-8524, Hyogo, Japan
- Laboratory of Analytics for Biomolecules, Faculty of Pharmaceutical Science, Setsunan University, 45-1 Nagaotoge-cho, Hirakata-shi 573-0101, Osaka, Japan;
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Trada Y, Lee MT, Jameson MG, Chlap P, Keall P, Moses D, Lin P, Fowler A. Mid-treatment 18F-FDG PET imaging changes in parotid gland correlates to radiation-induced xerostomia. Radiother Oncol 2023; 186:109745. [PMID: 37330056 DOI: 10.1016/j.radonc.2023.109745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/05/2023] [Accepted: 06/08/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The aim of this study was to measure functional changes in parotid glands using mid-treatment FDG-PET/CT and correlate early imaging changes to subsequent xerostomia in mucosal head and neck squamous cell carcinoma patients undergoing radiotherapy. MATERIALS AND METHODS 56 patients from two prospective imaging biomarker studies underwent FDG-PET/CT at baseline and during radiotherapy (week 3). Both parotid glands were volumetrically delineated at each time point. PET parameter SUVmedian were calculated for ipsilateral and contralateral parotid glands. Absolute and relative change (Δ) in SUVmedian were correlated to moderate-severe xerostomia (CTCAE grade ≥ 2) at 6 months. Four predictive models were subsequently created using multivariate logistic regression using clinical and radiotherapy planning parameters. Model performance was calculated using ROC analysis and compared using Akaike information criterion (AIC) RESULTS: 29 patients (51.8%) developed grade ≥ 2 xerostomia. Compared to baseline, there was an increase in SUVmedian at week 3 in ipsilateral (8.4%) and contralateral (5.5%) parotid glands. Increase in ipsilateral parotid Δ SUVmedian (p = 0.04) and contralateral mean parotid dose (p = 0.04) were correlated to xerostomia. The reference 'clinical' model correlated to xerostomia (AUC 0.667, AIC 70.9). Addition of ipsilateral parotid Δ SUVmedian to the clinical model resulted in the highest correlation to xerostomia (AUC 0.777, AIC 65.4). CONCLUSION Our study shows functional changes occurring in the parotid gland early during radiotherapy. We demonstrate that integration of baseline and mid-treatment FDG-PET/CT changes in the parotid gland with clinical factors has the potential to improve xerostomia risk prediction which could be utilised for personalised head and neck radiotherapy.
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Affiliation(s)
- Yuvnik Trada
- Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, NSW, Australia; Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
| | - Mark T Lee
- Department of Radiation Oncology, Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW, Australia; South Western Clinical School, School of Medicine, University of New South Wales, NSW, Australia
| | - Michael G Jameson
- GenesisCare, Sydney, NSW, Australia; St Vincent's Clinical School, Faculty of Medicine, University NSW, Australia
| | - Phillip Chlap
- Department of Radiation Oncology, Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW, Australia; South Western Clinical School, School of Medicine, University of New South Wales, NSW, Australia; Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Paul Keall
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Image X Institute, University of Sydney, Sydney, NSW, Australia
| | - Daniel Moses
- Graduate School of Biomedical Engineering, Faculty of Engineering, University of New South Wales, Sydney, Australia; Department of Medical Imaging, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Peter Lin
- South Western Clinical School, School of Medicine, University of New South Wales, NSW, Australia; Department of Nuclear Medicine and PET, Liverpool Hospital, Liverpool, NSW, Australia; School of Medicine, Western Sydney University, NSW, Australia
| | - Allan Fowler
- Department of Radiation Oncology, Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW, Australia; South Western Clinical School, School of Medicine, University of New South Wales, NSW, Australia
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Marinkovic M, Tran ON, Wang H, Abdul-Azees P, Dean DD, Chen XD, Yeh CK. Autologous mesenchymal stem cells offer a new paradigm for salivary gland regeneration. Int J Oral Sci 2023; 15:18. [PMID: 37165024 PMCID: PMC10172302 DOI: 10.1038/s41368-023-00224-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/20/2023] [Accepted: 03/29/2023] [Indexed: 05/12/2023] Open
Abstract
Salivary gland (SG) dysfunction, due to radiotherapy, disease, or aging, is a clinical manifestation that has the potential to cause severe oral and/or systemic diseases and compromise quality of life. Currently, the standard-of-care for this condition remains palliative. A variety of approaches have been employed to restore saliva production, but they have largely failed due to damage to both secretory cells and the extracellular matrix (niche). Transplantation of allogeneic cells from healthy donors has been suggested as a potential solution, but no definitive population of SG stem cells, capable of regenerating the gland, has been identified. Alternatively, mesenchymal stem cells (MSCs) are abundant, well characterized, and during SG development/homeostasis engage in signaling crosstalk with the SG epithelium. Further, the trans-differentiation potential of these cells and their ability to regenerate SG tissues have been demonstrated. However, recent findings suggest that the "immuno-privileged" status of allogeneic adult MSCs may not reflect their status post-transplantation. In contrast, autologous MSCs can be recovered from healthy tissues and do not present a challenge to the recipient's immune system. With recent advances in our ability to expand MSCs in vitro on tissue-specific matrices, autologous MSCs may offer a new therapeutic paradigm for restoration of SG function.
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Affiliation(s)
- Milos Marinkovic
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Research Service, South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Olivia N Tran
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Hanzhou Wang
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Parveez Abdul-Azees
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Research Service, South Texas Veterans Health Care System, San Antonio, TX, USA
| | - David D Dean
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, TX, USA
| | - Xiao-Dong Chen
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
- Research Service, South Texas Veterans Health Care System, San Antonio, TX, USA.
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, TX, USA.
| | - Chih-Ko Yeh
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
- Geriatric Research, Education and Clinical Center, South Texas Veterans Health Care System, San Antonio, TX, USA.
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Friedman E, Cai Y, Chen B. Imaging of Major Salivary Gland Lesions and Disease. Oral Maxillofac Surg Clin North Am 2023:S1042-3699(23)00009-2. [PMID: 37032181 DOI: 10.1016/j.coms.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Infectious and inflammatory disorders are the commonest pathologies to affect the major salivary glands however frequently overlap in clinical presentation. Imaging plays an important role in diagnosis, usually initially performed by CT or ultrasound. MRI, with its superior soft-tissue characterization compared with CT, provides a better evaluation of tumors and tumor-like conditions. Imaging features may suggest that a mass is more likely to be benign versus malignant, however, biopsy is often needed to establish a definitive histopathologic diagnosis. Imaging plays a key role in the staging of neoplastic disease.
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Affiliation(s)
- Elliott Friedman
- Department of Radiology, Houston Methodist Hospital, 6565 Fannin Street, Houston, TX 77030, USA.
| | - Yu Cai
- Ascension Seton Medical Center Austin, 1201 West 38th Street, Austin, TX 78705, USA
| | - Bo Chen
- Department of Diagnostic and Interventional Radiology, McGovern Medical School at the University of Texas HSC Houston, 6431 Fannin Street, MSB 2.130B, Houston, TX 77030, USA
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Dose response modelling of secretory cell loss in salivary glands using PSMA PET. Radiother Oncol 2022; 177:164-171. [PMID: 36368471 DOI: 10.1016/j.radonc.2022.10.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 10/07/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND PURPOSE Xerostomia remains a common side effect of radiotherapy (RT) for patients with head and neck (H&N) cancer despite advancements in treatment planning and delivery. Secretory salivary gland cells express the prostate-specific membrane antigen (PSMA), and show significant uptake on PET scans using 68Ga/18F-PSMA-ligands. We aimed to objectively quantify the dose-response of salivary glands to RT using PSMA PET. METHODS AND MATERIALS 28H&N cancer patients received RT with 70 Gy in 35 fractions over 7 weeks. PSMA PET/CT was acquired at baseline (BL), during treatment (DT) and at 1-&6-months post-treatment (PT1M/PT6M). Dose, BL- PT1M- and PT6M-SUV were extracted for every voxel inside each parotid (PG) and submandibular (SMG) gland. The PT1M/6M data was analysed using a generalised linear mixed effects model.Patient-reported xerostomia and DT-PSMA loss was also analysed. RESULTS Dose had a relative effect on BL SUV. For a population average gland (BL-SUV of 10), every 1 Gy increment, decreased the PT1M/PT6M-SUV by 1.6 %/1.6 % for PGs and by 0.9 %/1.8 % for SMGs. TD50 of the population curves was 26.5/31.3 Gy for PGs, and 22.9/27.8 Gy for SMGs at PT1M /PT6M. PSMA loss correlated well with patient-reported xerostomia at DT/PT1M (Spearman's ρ = -0.64, -0.50). CONCLUSION A strong relationship was demonstrated between radiation dose and loss of secretory cells in salivary glands derived using PSMA PET/CT. The population curve could potentially be used as a dose planning objective, by maximising the predicted post-treatment SUV. BL scans could be used to further tailor this to individual patients.
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Sample C, Jung N, Rahmim A, Uribe C, Clark H. Development of a CT-Based Auto-Segmentation Model for Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography-Delineated Tubarial Glands. Cureus 2022; 14:e31060. [DOI: 10.7759/cureus.31060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2022] [Indexed: 11/06/2022] Open
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Mohamed NH, Shawkat S, Moussa MS, Ahmed N. Regeneration potential of bone marrow derived mesenchymal stem cells and platelet rich plasma (PRP) on irradiation-induced damage of submandibular salivary gland in albino rats. Tissue Cell 2022; 76:101780. [PMID: 35395489 DOI: 10.1016/j.tice.2022.101780] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 02/19/2022] [Accepted: 03/05/2022] [Indexed: 02/04/2023]
Abstract
Radiation-induced damage to salivary glands (SG) is a consequence of radiotherapy for head and neck cancers. Recovery of the irradiated SG has been studied using various regenerative approaches. This study aims to compare the regenerative potentials of platelet-rich plasma (PRP) and bone marrow mononuclear cells (BMMCs) on irradiated rat submandibular salivary glands (SMD). 32 healthy male albino rats were irradiated with a single dose of 6 Gy then classified into four groups. Group A received no treatment while the other 3 groups were injected 24 h post-radiation with a single dose of either; BMMCs (Group B), PRP (Group C), or BMMCs suspended in PRP (Group D). SMD regeneration was assessed in terms of histological changes and TGF- β1 gene expression. The results showed that compared to the untreated group all groups showed successful regeneration with group D showing the best results. A statistically significant increase in the surface area of acini and TGF- β1 gene expression was observed in group D, followed by group C, then B. Our results prove that using PRP and BMMCs could be promising in decreasing irradiation side effects on SG. Moreover, combining PRP and BMMCs gives better effects compared to each therapy alone.
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Affiliation(s)
- N H Mohamed
- Oral Biology Department, Faculty of Dentistry, Cairo University, Mathaf-El-Manial Street, 11553, Cairo, Egypt; Oral Histopathology Department, Faculty of Oral and Dental Medicine, Misr International University, Km 28 Misr-Ismailia Road, Cairo, Egypt
| | - S Shawkat
- Oral Biology Department, Faculty of Dentistry, Cairo University, Mathaf-El-Manial Street, 11553, Cairo, Egypt
| | - M S Moussa
- Oral Biology Department, Faculty of Dentistry, Cairo University, Mathaf-El-Manial Street, 11553, Cairo, Egypt.
| | - Neb Ahmed
- Department of Oro-dental Genetics, Medical Research Centre of Excellence, National Research Centre, 33 El Buhouth St., Dokki, Cairo, Egypt; Stem Cell Laboratory, Centre of Excellence for Advanced Sciences, National Research Centre, 33 El Buhouth St., Dokki, Cairo, Egypt
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Meabed OM, Shamaa A, Abdelrahman IY, El-Sayyed GS, Mohammed SS. The Effect of Nano-chitosan and Nano-curcumin on Radiated Parotid Glands of Albino Rats: Comparative Study. J CLUST SCI 2022. [DOI: 10.1007/s10876-022-02281-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AbstractDecreasing the salivary flow rate manifested by xerostomia occurs early during the irradiation treatment. The duration of depressed salivary function varies among patients. Various histopathological changes occur in the salivary glands. The current study was performed to investigate and compare between the possible anti-radiotherapeutic effect of the gamma rays-synthesized curcumin nanoparticles (Cur NPs), and chitosan nanoparticles (Cs NPs). They were utilized to overcome the histopathological changes associated with radiation therapy in albino rats’ parotid glands. Sixty adult male Albino rats were utilized, fifteen as control group, fifteen as radiated group and thirty as Cur NPs and Cs NPs treatment groups. The parotid glands were dissected and examined histologically, immunohistochemically for vascular endothelial growth factor (VEGF) as well as histo-morphometrically. The histological results proved the antiradio-therapeutic effect of Cur NPs, and Cs NPs, with the least degenerative changes in the Cur NPs treated group. A high significant increase in VEGF was recorded in the radiated group as compared to the other treated groups. Cs NPs have proved to be an anti-radiotherapeutic and anti-oxidant substrate in treating the histopathological changes in radiated parotid glands of albino rats. However, it was lagging behind Cur NPs in all analyses but non-significant differences between them have been recorded.
Graphical Abstract
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18
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Rocha PHP, Reali RM, Decnop M, Souza SA, Teixeira LAB, Júnior AL, Sarpi MO, Cintra MB, Pinho MC, Garcia MRT. Adverse Radiation Therapy Effects in the Treatment of Head and Neck Tumors. Radiographics 2022; 42:806-821. [PMID: 35302867 DOI: 10.1148/rg.210150] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Whether used as a single modality or as part of a combined approach, radiation therapy (RT) plays an essential role in the treatment of several head and neck malignancies. Despite the improvement in radiation delivery techniques, normal structures in the vicinity of the target area remain susceptible to a wide range of adverse effects. Given their high incidence, some of these effects are referred to as expected postradiation changes (eg, mucositis, sialadenitis, and edema), while others are considered true complications, meaning they should not be expected and can even represent life-threatening conditions (eg, radionecrosis, fistulas, and radiation-induced neoplasms). Also, according to their timing of onset, these deleterious effects can be divided into four groups: acute (during RT), subacute (within weeks to months), delayed onset (within months to years), and very delayed onset (after several years).The authors provide a comprehensive review of the most important radiation-induced changes related to distinct head and neck sites, focusing on their typical cross-sectional imaging features and correlating them with the time elapsed after treatment. Radiologists should not only be familiar with these imaging findings but also actively seek essential clinical data at the time of interpretation (including knowledge of the RT dose and time, target site, and manifesting symptoms) to better recognize imaging findings, avoid pitfalls and help guide appropriate management. © RSNA, 2022.
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Affiliation(s)
- Pedro H P Rocha
- From the Division of Head and Neck Radiology, Diagnósticos da América SA/DASA, São Paulo, Brazil (P.H.P.R., R.M.R., S.A.S., M.O.S., M.B.C., M.R.T.G.); Division of Head and Neck Radiology, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.); Departments of Diagnostic Imaging (S.A.S., M.B.C.) and Radiation Therapy (L.A.B.T.), Instituto do Câncer do Estado de São Paulo (ICESP) do HCFMUSP, São Paulo, Brazil; Department of Radiation Therapy, Hospital Santa Paula, São Paulo, Brazil (L.A.B.T.); Division of Head and Neck and Neuroradiology, Grupo São Camilo/ DASA, Maringá, Brazil (A.L.J.); Division of Head and Neck Radiology, Instituto de Radiologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/ HC-FMUSP), São Paulo, Brazil (M.O.S.); and Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (M.C.P.)
| | - Raphael M Reali
- From the Division of Head and Neck Radiology, Diagnósticos da América SA/DASA, São Paulo, Brazil (P.H.P.R., R.M.R., S.A.S., M.O.S., M.B.C., M.R.T.G.); Division of Head and Neck Radiology, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.); Departments of Diagnostic Imaging (S.A.S., M.B.C.) and Radiation Therapy (L.A.B.T.), Instituto do Câncer do Estado de São Paulo (ICESP) do HCFMUSP, São Paulo, Brazil; Department of Radiation Therapy, Hospital Santa Paula, São Paulo, Brazil (L.A.B.T.); Division of Head and Neck and Neuroradiology, Grupo São Camilo/ DASA, Maringá, Brazil (A.L.J.); Division of Head and Neck Radiology, Instituto de Radiologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/ HC-FMUSP), São Paulo, Brazil (M.O.S.); and Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (M.C.P.)
| | - Marcos Decnop
- From the Division of Head and Neck Radiology, Diagnósticos da América SA/DASA, São Paulo, Brazil (P.H.P.R., R.M.R., S.A.S., M.O.S., M.B.C., M.R.T.G.); Division of Head and Neck Radiology, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.); Departments of Diagnostic Imaging (S.A.S., M.B.C.) and Radiation Therapy (L.A.B.T.), Instituto do Câncer do Estado de São Paulo (ICESP) do HCFMUSP, São Paulo, Brazil; Department of Radiation Therapy, Hospital Santa Paula, São Paulo, Brazil (L.A.B.T.); Division of Head and Neck and Neuroradiology, Grupo São Camilo/ DASA, Maringá, Brazil (A.L.J.); Division of Head and Neck Radiology, Instituto de Radiologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/ HC-FMUSP), São Paulo, Brazil (M.O.S.); and Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (M.C.P.)
| | - Soraia A Souza
- From the Division of Head and Neck Radiology, Diagnósticos da América SA/DASA, São Paulo, Brazil (P.H.P.R., R.M.R., S.A.S., M.O.S., M.B.C., M.R.T.G.); Division of Head and Neck Radiology, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.); Departments of Diagnostic Imaging (S.A.S., M.B.C.) and Radiation Therapy (L.A.B.T.), Instituto do Câncer do Estado de São Paulo (ICESP) do HCFMUSP, São Paulo, Brazil; Department of Radiation Therapy, Hospital Santa Paula, São Paulo, Brazil (L.A.B.T.); Division of Head and Neck and Neuroradiology, Grupo São Camilo/ DASA, Maringá, Brazil (A.L.J.); Division of Head and Neck Radiology, Instituto de Radiologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/ HC-FMUSP), São Paulo, Brazil (M.O.S.); and Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (M.C.P.)
| | - Lorine A B Teixeira
- From the Division of Head and Neck Radiology, Diagnósticos da América SA/DASA, São Paulo, Brazil (P.H.P.R., R.M.R., S.A.S., M.O.S., M.B.C., M.R.T.G.); Division of Head and Neck Radiology, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.); Departments of Diagnostic Imaging (S.A.S., M.B.C.) and Radiation Therapy (L.A.B.T.), Instituto do Câncer do Estado de São Paulo (ICESP) do HCFMUSP, São Paulo, Brazil; Department of Radiation Therapy, Hospital Santa Paula, São Paulo, Brazil (L.A.B.T.); Division of Head and Neck and Neuroradiology, Grupo São Camilo/ DASA, Maringá, Brazil (A.L.J.); Division of Head and Neck Radiology, Instituto de Radiologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/ HC-FMUSP), São Paulo, Brazil (M.O.S.); and Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (M.C.P.)
| | - Ademar Lucas Júnior
- From the Division of Head and Neck Radiology, Diagnósticos da América SA/DASA, São Paulo, Brazil (P.H.P.R., R.M.R., S.A.S., M.O.S., M.B.C., M.R.T.G.); Division of Head and Neck Radiology, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.); Departments of Diagnostic Imaging (S.A.S., M.B.C.) and Radiation Therapy (L.A.B.T.), Instituto do Câncer do Estado de São Paulo (ICESP) do HCFMUSP, São Paulo, Brazil; Department of Radiation Therapy, Hospital Santa Paula, São Paulo, Brazil (L.A.B.T.); Division of Head and Neck and Neuroradiology, Grupo São Camilo/ DASA, Maringá, Brazil (A.L.J.); Division of Head and Neck Radiology, Instituto de Radiologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/ HC-FMUSP), São Paulo, Brazil (M.O.S.); and Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (M.C.P.)
| | - Maíra O Sarpi
- From the Division of Head and Neck Radiology, Diagnósticos da América SA/DASA, São Paulo, Brazil (P.H.P.R., R.M.R., S.A.S., M.O.S., M.B.C., M.R.T.G.); Division of Head and Neck Radiology, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.); Departments of Diagnostic Imaging (S.A.S., M.B.C.) and Radiation Therapy (L.A.B.T.), Instituto do Câncer do Estado de São Paulo (ICESP) do HCFMUSP, São Paulo, Brazil; Department of Radiation Therapy, Hospital Santa Paula, São Paulo, Brazil (L.A.B.T.); Division of Head and Neck and Neuroradiology, Grupo São Camilo/ DASA, Maringá, Brazil (A.L.J.); Division of Head and Neck Radiology, Instituto de Radiologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/ HC-FMUSP), São Paulo, Brazil (M.O.S.); and Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (M.C.P.)
| | - Murilo B Cintra
- From the Division of Head and Neck Radiology, Diagnósticos da América SA/DASA, São Paulo, Brazil (P.H.P.R., R.M.R., S.A.S., M.O.S., M.B.C., M.R.T.G.); Division of Head and Neck Radiology, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.); Departments of Diagnostic Imaging (S.A.S., M.B.C.) and Radiation Therapy (L.A.B.T.), Instituto do Câncer do Estado de São Paulo (ICESP) do HCFMUSP, São Paulo, Brazil; Department of Radiation Therapy, Hospital Santa Paula, São Paulo, Brazil (L.A.B.T.); Division of Head and Neck and Neuroradiology, Grupo São Camilo/ DASA, Maringá, Brazil (A.L.J.); Division of Head and Neck Radiology, Instituto de Radiologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/ HC-FMUSP), São Paulo, Brazil (M.O.S.); and Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (M.C.P.)
| | - Marco C Pinho
- From the Division of Head and Neck Radiology, Diagnósticos da América SA/DASA, São Paulo, Brazil (P.H.P.R., R.M.R., S.A.S., M.O.S., M.B.C., M.R.T.G.); Division of Head and Neck Radiology, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.); Departments of Diagnostic Imaging (S.A.S., M.B.C.) and Radiation Therapy (L.A.B.T.), Instituto do Câncer do Estado de São Paulo (ICESP) do HCFMUSP, São Paulo, Brazil; Department of Radiation Therapy, Hospital Santa Paula, São Paulo, Brazil (L.A.B.T.); Division of Head and Neck and Neuroradiology, Grupo São Camilo/ DASA, Maringá, Brazil (A.L.J.); Division of Head and Neck Radiology, Instituto de Radiologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/ HC-FMUSP), São Paulo, Brazil (M.O.S.); and Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (M.C.P.)
| | - Marcio R T Garcia
- From the Division of Head and Neck Radiology, Diagnósticos da América SA/DASA, São Paulo, Brazil (P.H.P.R., R.M.R., S.A.S., M.O.S., M.B.C., M.R.T.G.); Division of Head and Neck Radiology, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.); Departments of Diagnostic Imaging (S.A.S., M.B.C.) and Radiation Therapy (L.A.B.T.), Instituto do Câncer do Estado de São Paulo (ICESP) do HCFMUSP, São Paulo, Brazil; Department of Radiation Therapy, Hospital Santa Paula, São Paulo, Brazil (L.A.B.T.); Division of Head and Neck and Neuroradiology, Grupo São Camilo/ DASA, Maringá, Brazil (A.L.J.); Division of Head and Neck Radiology, Instituto de Radiologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/ HC-FMUSP), São Paulo, Brazil (M.O.S.); and Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (M.C.P.)
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El Shahawy M, El Deeb M. Assessment of the possible ameliorative effect of curcumin nanoformulation on the submandibular salivary gland of alloxan-induced diabetes in a rat model (Light microscopic and ultrastructural study). Saudi Dent J 2022; 34:375-384. [PMID: 35814842 PMCID: PMC9263756 DOI: 10.1016/j.sdentj.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/17/2022] [Accepted: 04/22/2022] [Indexed: 11/28/2022] Open
Abstract
Background Objective Methods Results Conclusion
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Chibly AM, Aure MH, Patel VN, Hoffman MP. Salivary Gland Function, Development and Regeneration. Physiol Rev 2022; 102:1495-1552. [PMID: 35343828 DOI: 10.1152/physrev.00015.2021] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Salivary glands produce and secrete saliva, which is essential for maintaining oral health and overall health. Understanding both the unique structure and physiological function of salivary glands, as well as how they are affected by disease and injury will direct the development of therapy to repair and regenerate them. Significant recent advances, particularly in the OMICS field, increase our understanding of how salivary glands develop at the cellular, molecular and genetic levels; the signaling pathways involved, the dynamics of progenitor cell lineages in development, homeostasis and regeneration and the role of the extracellular matrix microenvironment. These provide a template for cell and gene therapies as well as bioengineering approaches to repair or regenerate salivary function.
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Affiliation(s)
- Alejandro Martinez Chibly
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, United States
| | - Marit H Aure
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, United States
| | - Vaishali N Patel
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, United States
| | - Matthew Philip Hoffman
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, United States
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21
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Cucu I, Nicolescu MI. A Synopsis of Signaling Crosstalk of Pericytes and Endothelial Cells in Salivary Gland. Dent J (Basel) 2021; 9:dj9120144. [PMID: 34940041 PMCID: PMC8700478 DOI: 10.3390/dj9120144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 12/12/2022] Open
Abstract
The salivary gland (SG) microvasculature constitutes a dynamic cellular organization instrumental to preserving tissue stability and homeostasis. The interplay between pericytes (PCs) and endothelial cells (ECs) culminates as a key ingredient that coordinates the development, maturation, and integrity of vessel building blocks. PCs, as a variety of mesenchymal stem cells, enthrall in the field of regenerative medicine, supporting the notion of regeneration and repair. PC-EC interconnections are pivotal in the kinetic and intricate process of angiogenesis during both embryological and post-natal development. The disruption of this complex interlinkage corresponds to SG pathogenesis, including inflammation, autoimmune disorders (Sjögren’s syndrome), and tumorigenesis. Here, we provided a global portrayal of major signaling pathways between PCs and ECs that cooperate to enhance vascular steadiness through the synergistic interchange. Additionally, we delineated how the crosstalk among molecular networks affiliate to contribute to a malignant context. Additionally, within SG microarchitecture, telocytes and myoepithelial cells assemble a labyrinthine companionship, which together with PCs appear to synchronize the regenerative potential of parenchymal constituents. By underscoring the intricacy of signaling cascades within cellular latticework, this review sketched a perceptive basis for target-selective drugs to safeguard SG function.
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Affiliation(s)
- Ioana Cucu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Mihnea Ioan Nicolescu
- Division of Histology, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Laboratory of Radiobiology, “Victor Babeș” National Institute of Pathology, 050096 Bucharest, Romania
- Correspondence:
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22
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Prevalence of different fungal species in Saliva and Swab samples of patients undergoing Radiotherapy for Oral Cancer. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2021. [DOI: 10.22207/jpam.15.3.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Oral cancer is one of the leading causes of morbidity and mortality globally. There is a lack of studies on the growth of different Candida species in swab pre and post-radiotherapy. Hence, this study aimed to determine different Candida species in the oral cavity of patients who undergo radiotherapy. The study included 50 patients with oral cancer scheduled to undergo radiotherapy. Both saliva and swab samples were collected from all the patients before and after two- and six weeks of starting the radiotherapy. Similar inoculation was performed using the salivary swabs and incubated aerobically at 37°C for 48h. After 48h, culture plates were removed from the incubator and observed for the growth of different fungal species based on the color of the colonies. The culture of samples from patients with oral cancer resulted in the growth of 68% of Candida species in saliva and 44% in swab before initiating radiation. Unlike baseline findings, Candida albicans were identified in a higher number in swab samples (44%) than saliva (24%) post two weeks of radiotherapy. All saliva samples were positive to candida species, in which Candida albicans shows high prevalence (24%). After six weeks of radiotherapy, in the swab, 30% of samples were positive for Candida albicans, and 18% of samples were positive for non-albicans species. Before radiotherapy, at two weeks and six weeks of radiotherapy, saliva samples showed a higher prevalence of Candidal species compared to swab samples. The combination of other Candida species was also higher in saliva samples compared to swab samples during radiotherapy.
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23
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Luo SD, Chiu TJ, Chen WC, Wang CS. Sex Differences in Otolaryngology: Focus on the Emerging Role of Estrogens in Inflammatory and Pro-Resolving Responses. Int J Mol Sci 2021; 22:ijms22168768. [PMID: 34445474 PMCID: PMC8395901 DOI: 10.3390/ijms22168768] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/09/2021] [Accepted: 08/13/2021] [Indexed: 12/02/2022] Open
Abstract
Otolaryngology (also known as ear, nose, and throat (ENT)) diseases can be significantly affected by the level of sex hormones, which indicates that sex differences affect the manifestation, pathophysiology, and outcomes of these diseases. Recently, increasing evidence has suggested that proinflammatory responses in ENT diseases are linked to the level of sex hormones. The sex hormone receptors are present on a wide variety of immune cells; therefore, it is evident that they play crucial roles in regulating the immune system and hence affect the disease progression of ENT diseases. In this review, we focus on how sex hormones, particularly estrogens, regulate ENT diseases, such as chronic rhinosinusitis, vocal fold polyps, thyroid cancer, Sjögren’s syndrome, and head and neck cancers, from the perspectives of inflammatory responses and specialized proresolving mediator-driven resolution. This paper aims to clarify why considering sex differences in the field of basic and medical research on otolaryngology is a key component to successful therapy for both males and females in the future.
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Affiliation(s)
- Sheng-Dean Luo
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (S.-D.L.); (W.-C.C.)
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Tai-Jan Chiu
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
- Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Wei-Chih Chen
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (S.-D.L.); (W.-C.C.)
| | - Ching-Shuen Wang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- Correspondence: ; Tel.: +886-227-361-661 (ext. 5166)
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24
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Bruvo M, Mahmood F. Apparent diffusion coefficient measurement of the parotid gland parenchyma. Quant Imaging Med Surg 2021; 11:3812-3829. [PMID: 34341752 DOI: 10.21037/qims-20-1178] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/18/2021] [Indexed: 12/14/2022]
Abstract
The measurements of apparent diffusion coefficient (ADC) with diffusion weighted magnetic resonance imaging (DW-MRI) is becoming a popular diagnostic and research tool for examination of parotid glands. However, there is little agreement between the reported ADC values of the parotid gland in published literature. In this review 43 studies on ADC measurement of the parotid glands were included. The analyses indicated several possible culprits of the observed ADC discrepancies. For example, DW-MRI examinations under gustatory stimulation gives higher ADC values compared to the unstimulated parotid gland (P=0.003). The diffusion weighting factors (b-values) can either increase (b-value <200 s/mm2) or decrease ADC values (b-values >1,000 s/mm2). The timing of follow-up DW-MRI after radiotherapy (RT) indicates correlation to the found ADC values (R2 =0.39). Interestingly, the choice of regions of interest (ROI) appears not to affect the measurements of ADC (P=0.75). It can be concluded that there is a critical need for standardization of ADC measurement of the parotid glands to allow valid inter-study comparisons and eventually to reach consensus on the use of ADC as biomarker.
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Affiliation(s)
- Maja Bruvo
- Radiography, Department of Technology, Faculty of Health, University College Copenhagen, Copenhagen, Denmark
| | - Faisal Mahmood
- Laboratory of Radiation Physics, Department of Oncology, Odense University Hospital, Odense, Denmark.,Research Unit for Oncology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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25
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Wang CC, Liao JS, Lai HC, Lo YH. The Mandarin Voice Handicap Index for Laryngectomees With Pneumatic Artificial Laryngeal and Esophageal Speech. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1781-1792. [PMID: 34157240 DOI: 10.1044/2021_ajslp-20-00241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose The Voice Handicap Index (VHI) questionnaire assesses the impact of total laryngectomy on voice-related quality of life. This study evaluates the Mandarin VHI, including its internal consistency, test-retest reliability, content validity, and differences in scores for Mandarin alaryngeal patients with pneumatic artificial laryngeal (PA) and esophageal (ES) speech. Method Translation and validation of the VHI questionnaire was performed through the forward-backward translation technique. This study used a sample of 78 PA and 23 ES participants from Taiwan who completed the Mandarin VHI. Forty-two of the alaryngeal participants completed the Mandarin VHI twice over a period of 7-63 days. Results The measurement of the internal consistency of the Mandarin VHI showed a high Cronbach's alpha coefficient for the total score (.975) and the functional (.930), physical (.939), and emotional (.938) subscales. Based on the results of the intraclass correlation coefficients, good test-retest reliability for the total and domain scores was found (intraclass correlation coefficient = .827-.863). Conclusion The Mandarin VHI was validated as an instrument with proper internal consistency and reliability, which supports the Mandarin VHI as a valid instrument for the self-evaluation of handicaps related to voice problems in PA and ES speakers.
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Affiliation(s)
- Chen-Chi Wang
- Department of Otolaryngology-Head & Neck Surgery, Taichung Veterans General Hospital, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Speech Language Pathology and Audiology, Chung Shan Medical University, Taichung, Taiwan
- Department of Audiology and Speech-Language Pathology, Asia University, Taichung, Taiwan
| | - Jia-Shiou Liao
- Department of Speech Language Pathology and Audiology, Chung Shan Medical University, Taichung, Taiwan
- Speech and Language Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hsiu-Chin Lai
- Department of Otolaryngology-Head & Neck Surgery, Taichung Veterans General Hospital, Taiwan
| | - Yi-Hsuan Lo
- Department of Otolaryngology-Head & Neck Surgery, Taichung Veterans General Hospital, Taiwan
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26
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Sumner W, Ray X, Sutton L, Rebibo D, Marincola F, Sanghvi P, Moiseenko V, Deichaite I. Gene alterations as predictors of radiation-induced toxicity in head and neck squamous cell carcinoma. J Transl Med 2021; 19:212. [PMID: 34001187 PMCID: PMC8130372 DOI: 10.1186/s12967-021-02876-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/05/2021] [Indexed: 01/02/2023] Open
Abstract
Background Optimizing the therapeutic ratio for radiation therapy (RT) in head and neck squamous cell carcinoma (HNSCC) is uniquely challenging owing to high rates of early and late toxicity involving nearby organs at risk. These toxicities have a profound impact on treatment compliance and quality of life. Emerging evidence suggests that RT dose alone cannot fully account for the variable severity of RT-related adverse events (rtAEs) observed in HNSCC patients. Next-generation sequencing has become an increasingly valuable tool with widespread use in the oncology field and is being robustly explored for predicting rtAEs beyond dosimetric data. Methods Patients who had Foundation Medicine sequencing data and received RT for primary or locally recurrent HNSCC were selected for this study. Early and late toxicity data were collected and reported based on Common Terminology Criteria for Adverse Events version 5.0. Dosimetric parameters were collected for pertinent structures. Results A total of HNSCC 37 patients were analyzed in this study. Genetic alterations in BRCA2, ERBB3, NOTCH1 and CCND1 were all associated with higher mean grade of toxicity with BRCA2 alteration implicated in all toxicity parameters evaluated including mucositis, early dysphagia, xerostomia and to a lesser extent, late dysphagia. Interestingly, patients who exhibited alterations in both BRCA2 and ERBB3 experienced a twofold or greater increase in early dysphagia, early xerostomia and late dysphagia compared to ERBB3 alteration alone. Furthermore, several gene alterations were associated with improved toxicity outcomes. Within an RT supersensitive patient subset, alterations were found in TNFAIP3, HNF1A, SPTA1 and CASP8. All of these alterations were not found in the RT insensitive patient subset. We found 17 gene alterations in the RT insensitive patient subset that were not found in the RT supersensitive patient subset. Conclusion Despite consistent RT dosimetric parameters, patients with HNSCC experience heterogeneous patterns of rtAEs. Identifying factors associated with toxicity outcomes offers a new avenue for personalized precision RT therapy and prophylactic management. Here, next-generation sequencing in a population of HNSCC patients correlates several genetic alterations with severity of rtAEs. Further analysis is urgently needed to identify genetic patterns associated with rtAEs in order to reduce harmful outcomes in this challenging population. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-021-02876-5.
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Affiliation(s)
- Whitney Sumner
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA
| | - Xenia Ray
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA
| | - Leisa Sutton
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Daniel Rebibo
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | | | - Parag Sanghvi
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA
| | - Vitali Moiseenko
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA
| | - Ida Deichaite
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA. .,Moores Cancer Center, University of California San Diego, La Jolla, CA, USA.
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27
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Cho JM, Yoon YJ, Lee S, Kim D, Choi D, Kim J, Lim JY. Retroductal Delivery of Epidermal Growth Factor Protects Salivary Progenitors after Irradiation. J Dent Res 2021; 100:883-890. [PMID: 33754871 DOI: 10.1177/0022034521999298] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Salivary gland hypofunction after irradiation is associated with a deficit of epithelial stem/progenitors in salivary glands. Although epidermal growth factor (EGF) is known to stimulate the proliferation of epithelial cells, the therapeutic effect of EGF on salivary epithelial stem/progenitors remains undetermined. In this study, we administered EGF to submandibular glands (SMGs) via a retrograde route through the SMG excretory duct before fractionated irradiation and examined whether EGF could protect salivary epithelial progenitor cells from radiation and alleviate radiation-induced salivary hypofunction. EGF-treated mice exhibited greater body and gland weights at 12 wk after irradiation than untreated mice. The retroductal delivery of EGF improved salivary secretory function and increased salivary amylase activity in a dose-dependent manner. Histological examinations highlighted the amelioration of the loss of keratine-14+ (KRT14+) basal ductal and/or MIST1+ acinar cells, as well as induction of fibrosis, following irradiation in EGF-treated mice. An additional in vitro experiment using a salivary gland organoid irradiation model indicated that the radioprotective effects of EGF promoted the growth and inhibited the apoptotic cell death of salivary epithelial cells. Our results suggest that retroductal delivery of EGF may be a promising therapeutic option for preventing radiation-induced salivary gland hypofunction.
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Affiliation(s)
- J M Cho
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Y J Yoon
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - S Lee
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - D Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - D Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - J Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - J Y Lim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
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28
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Mohan V, Bruin NM, van de Kamer JB, Sonke JJ, Vogel WV. The increasing potential of nuclear medicine imaging for the evaluation and reduction of normal tissue toxicity from radiation treatments. Eur J Nucl Med Mol Imaging 2021; 48:3762-3775. [PMID: 33687522 PMCID: PMC8484246 DOI: 10.1007/s00259-021-05284-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/24/2021] [Indexed: 11/26/2022]
Abstract
Radiation therapy is an effective treatment modality for a variety of cancers. Despite several advances in delivery techniques, its main drawback remains the deposition of dose in normal tissues which can result in toxicity. Common practices of evaluating toxicity, using questionnaires and grading systems, provide little underlying information beyond subjective scores, and this can limit further optimization of treatment strategies. Nuclear medicine imaging techniques can be utilised to directly measure regional baseline function and function loss from internal/external radiation therapy within normal tissues in an in vivo setting with high spatial resolution. This can be correlated with dose delivered by radiotherapy techniques to establish objective dose-effect relationships, and can also be used in the treatment planning step to spare normal tissues more efficiently. Toxicity in radionuclide therapy typically occurs due to undesired off-target uptake in normal tissues. Molecular imaging using diagnostic analogues of therapeutic radionuclides can be used to test various interventional protective strategies that can potentially reduce this normal tissue uptake without compromising tumour uptake. We provide an overview of the existing literature on these applications of nuclear medicine imaging in diverse normal tissue types utilising various tracers, and discuss its future potential.
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Affiliation(s)
- V Mohan
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - N M Bruin
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J B van de Kamer
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - J-J Sonke
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Wouter V Vogel
- Department of Nuclear Medicine, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
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29
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Fan WJ, Teng F, Liu G, Zhao DW, Li JF, Luo YR, Zhang XX, Ma L, Guan J. Diffusion weighted imaging in submandibular gland sparing helical tomotherapy for nasopharyngeal carcinoma. Radiother Oncol 2021; 157:247-254. [PMID: 33587972 DOI: 10.1016/j.radonc.2021.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/31/2021] [Accepted: 02/01/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE To verify clinical significance of submandibular gland (SMG)-sparing during helical tomotherapy (HT) for nasopharyngeal carcinoma (NPC) from the perspective of imaging by using diffusion weighted imaging (DWI). MATERIALS AND METHODS In this prospective study, 60 NPC patients scheduled for radical SMG-sparing HT were enrolled. All patients underwent DWI examinations prior to HT (pre-HT) and 1, 3, 6, 9, 12 months post HT. Mean apparent diffusion coefficient (ADC) values of bilateral parotid glands (PGs) and submandibular glands (SMGs) were measured. Differences of ADC and changes of ADC pre and pro HT (ΔADC) among SMG-spared, SMG-unspared and PGs were compared and the associations betweenΔADC and variations of patient-rated xerostomia questionnaire summary scores (XQ-sum) were further tested. RESULTS ADCpost-HT and ΔADCpost-HT of SMG-spared were both much lower than of SMG-unspared and a strong dose-response relationship was detected between mean radiation dose and ΔADC of SMGs. Dynamic change trends of PGs, SMG-spared and SMG-unspared were similar, with initial increase at 1 m-post-HT followed by little change at 3 m-post-HT and then gradual decrease over time. But for SMG-unspared, there was no obvious change of ADC from 6 m-post-HT to 12 m-post-HT. The dynamic change trend of XQ-sum was nearly in line with that of ADC on the whole. And a positive correlation between mean ΔADC1m-post-HT of bilateral SMGs and variation of XQ-sum1m-post-HT in patients with bSMG-unspared were found (r = 0.693, P < 0.001). Multivariate stepwise regression analysis showed that whether spared SMG or not was the only independent predictor correlated to XQ-sumpost-HT at each follow-up timepoint. CONCLUSION SMG-sparing technique could significantly improve subjective xerostomia post HT in NPC patients from the perspective of imaging.
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Affiliation(s)
- Wen-Jun Fan
- Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, China; Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Radiation Oncology, First Medical Center of Chinese PLA General Hospital, Beijing, China; Armed Police Corps Hospital of Henan Province, Zhengzhou, China
| | - Feng Teng
- Department of Radiation Oncology, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Gang Liu
- Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Da-Wei Zhao
- Department of Radiation Oncology, First Medical Center of Chinese PLA General Hospital, Beijing, China; Department of Radiology, Pingjin Hospital, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin, China
| | - Jin-Feng Li
- Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yan-Rong Luo
- Department of Radiation Oncology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xin-Xin Zhang
- Department of Otolaryngology, First Medical Center of Chinese PLA General Hospital, Beijing, China.
| | - Lin Ma
- Department of Radiation Oncology, First Medical Center of Chinese PLA General Hospital, Beijing, China.
| | - Jian Guan
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
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30
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Yang J, Wei R, Song X, Sun X, Wang H, Liu Q, Hu L, Yu H, Wang D. Risk of second primary malignancy after minor salivary gland cancer: A Surveillance, Epidemiology, and End Results database analysis. Head Neck 2021; 43:1769-1779. [PMID: 33590552 DOI: 10.1002/hed.26641] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 12/20/2020] [Accepted: 02/02/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Minor salivary gland cancer (MiSGC) is a group of tumors with varied disease course in the head and neck. We evaluated the risk of a second primary malignancy (SPM) in MiSGC patients and identified possible prognostic factors for survival using a large population database. METHODS We used the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) data to evaluate the risk and prognosis of SPM in patients diagnosed with MiSGC. RESULTS The risk of SPM increased in MiSGC patients compared with the endemic rate. The risk of SPM was slightly greater in female patients and who underwent radiotherapy. Age at primary diagnosis, sex, race, year of diagnosis, SEER stage, radiotherapy, SPM, histology, and tumor site were significant survival prognostic indicators of MiSGC patients. CONCLUSION Radiotherapy and female sex were risk factors for SPM after MiSGC. Long-term surveillance for SPM was important in MiSGC patients.
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Affiliation(s)
- Jingyi Yang
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Ruoyan Wei
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Xiaole Song
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Xicai Sun
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Huan Wang
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Quan Liu
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Li Hu
- Department of Experimental Center, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Hongmeng Yu
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China.,Research Units of New Technologies of Endoscopic Surgery in Skull Base Tumor, Chinese Academy of Medical Sciences, Shanghai, China
| | - Dehui Wang
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
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31
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Sample CM, Wu J, Thomas S, Clark H. Incorporating parotid gland inhomogeneity into head-and-neck treatment optimization through the use of artificial base plans. J Appl Clin Med Phys 2021; 22:141-149. [PMID: 33565210 PMCID: PMC7984464 DOI: 10.1002/acm2.13192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/30/2020] [Accepted: 01/17/2021] [Indexed: 11/06/2022] Open
Abstract
Despite a great improvement in target volume dose conformality made possible in recent years by modulated therapies, xerostomia remains a common and severe side effect for head-and-neck radiotherapy patients. It is known that parotid glands exhibit a spatially varying dose response; however, the relative importance of subregions throughout the entire gland has yet to be incorporated into treatment plan optimization, with the current standard being to minimize the mean dose to whole parotid glands. The relative importance of regions within contralateral parotid glands has been recently quantified, creating an opportunity for the development of a method for including this data in plan optimization. We present a universal and straightforward approach for imposing varying sub-parotid gland dose constraints during inverse treatment planning by using patient-specific artificial base plans to penalize dose deposited in sensitive regions. In this work, the proposed method of optimization is demonstrated to reduce dose to regions of high relative importance throughout contralateral parotids and improve predictions for stimulated saliva output at 1-year post-radiotherapy. This method may also be applied to impose varying dose constraints to other organs-at-risk for which regional importance data exists.
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Affiliation(s)
- Caleb M Sample
- Department of Medical Physics, BC Cancer Agency, Vancouver, BC, Canada.,Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada
| | - Jonn Wu
- Department of Radiation Oncology, BC Cancer Agency, Vancouver, BC, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Steven Thomas
- Department of Medical Physics, BC Cancer Agency, Vancouver, BC, Canada
| | - Haley Clark
- Department of Medical Physics, BC Cancer Agency, Surrey, BC, Canada
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32
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Radiation-Induced Salivary Gland Dysfunction: Mechanisms, Therapeutics and Future Directions. J Clin Med 2020; 9:jcm9124095. [PMID: 33353023 PMCID: PMC7767137 DOI: 10.3390/jcm9124095] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 12/14/2022] Open
Abstract
Salivary glands sustain collateral damage following radiotherapy (RT) to treat cancers of the head and neck, leading to complications, including mucositis, xerostomia and hyposalivation. Despite salivary gland-sparing techniques and modified dosing strategies, long-term hypofunction remains a significant problem. Current therapeutic interventions provide temporary symptom relief, but do not address irreversible glandular damage. In this review, we summarize the current understanding of mechanisms involved in RT-induced hyposalivation and provide a framework for future mechanistic studies. One glaring gap in published studies investigating RT-induced mechanisms of salivary gland dysfunction concerns the effect of irradiation on adjacent non-irradiated tissue via paracrine, autocrine and direct cell-cell interactions, coined the bystander effect in other models of RT-induced damage. We hypothesize that purinergic receptor signaling involving P2 nucleotide receptors may play a key role in mediating the bystander effect. We also discuss promising new therapeutic approaches to prevent salivary gland damage due to RT.
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Louzeiro GC, Teixeira DDS, Cherubini K, de Figueiredo MAZ, Salum FG. Does laser photobiomodulation prevent hyposalivation in patients undergoing head and neck radiotherapy? A systematic review and meta-analysis of controlled trials. Crit Rev Oncol Hematol 2020; 156:103115. [PMID: 33039721 DOI: 10.1016/j.critrevonc.2020.103115] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 08/07/2020] [Accepted: 09/25/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Head and neck radiotherapy can cause hypofunction of the salivary glands. Many studies report that laser photobiomodulation (PBM) is able to minimize radiation-induced hyposalivation, yet there is no consensus about its effects. OBJECTIVE To carry out a meta-analysis of controlled clinical trials that used PBM to prevent radiation-induced hyposalivation. METHODS A systematic search was performed through Embase, Medline/PubMed, Cochrane, EBSCO, Scopus, LILACS and Web of Science databases. The strategy included comparisons of the effect of PBM with placebo/clinical follow-up on unstimulated and/or stimulated salivary flow in patients undergoing head and neck radiotherapy. RESULTS Six clinical trials were included, five of which were used for meta-analysis. Evidence was observed between the use of PBM and increased unstimulated salivary flow (MD 0.20 mL/min, 95 % Cl 0.10-0.30, I² = 96 %, p < 0.00001) and in stimulated salivary flow (MD 0.27 mL/min, 95 % CI 0.08-0.46, I² = 95 %, p < 0.00001). CONCLUSION PBM appears to minimize radiation-induced hyposalivation.
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Affiliation(s)
- Gabriel Campos Louzeiro
- School of Health and Life Sciences, Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Dieni da Silveira Teixeira
- School of Health and Life Sciences, Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Karen Cherubini
- School of Health and Life Sciences, Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Maria Antonia Zancanaro de Figueiredo
- School of Health and Life Sciences, Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernanda Gonçalves Salum
- School of Health and Life Sciences, Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
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Barrows CM, Wu D, Farach-Carson MC, Young S. Building a Functional Salivary Gland for Cell-Based Therapy: More than Secretory Epithelial Acini. Tissue Eng Part A 2020; 26:1332-1348. [PMID: 32829674 PMCID: PMC7759264 DOI: 10.1089/ten.tea.2020.0184] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/20/2020] [Indexed: 11/13/2022] Open
Abstract
A few treatment options exist for patients experiencing xerostomia due to hyposalivation that occurs as a result of disease or injury to the gland. An opportunity for a permanent solution lies in the field of salivary gland replacement through tissue engineering. Recent success emboldens in the vision of producing a tissue-engineered salivary gland composed of differentiated salivary epithelial cells that are able to differentiate to form functional units that produce and deliver saliva to the oral cavity. This vision is augmented by advances in understanding cellular mechanisms that guide branching morphogenesis and salivary epithelial cell polarization in both acinar and ductal structures. Growth factors and other guidance cues introduced into engineered constructs help to develop a more complex glandular structure that seeks to mimic native salivary gland tissue. This review describes the separate epithelial phenotypes that make up the gland, and it describes their relationship with the other cell types such as nerve and vasculature that surround them. The review is organized around the links between the native components that form and contribute to various aspects of salivary gland development, structure, and function and how this information can drive the design of functional tissue-engineered constructs. In addition, we discuss the attributes of various biomaterials commonly used to drive function and form in engineered constructs. The review also contains a current description of the state-of-the-art of the field, including successes and challenges in creating materials for preclinical testing in animal models. The ability to integrate biomolecular cues in combination with a range of materials opens the door to the design of increasingly complex salivary gland structures that, once accomplished, can lead to breakthroughs in other fields of tissue engineering of epithelial-based exocrine glands or oral tissues.
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Affiliation(s)
- Caitlynn M.L. Barrows
- Department of Diagnostic and Biomedical Sciences and The University of Texas Health Science Center at Houston, School of Dentistry, Houston, Texas, USA
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, School of Dentistry, Houston, Texas, USA
| | - Danielle Wu
- Department of Diagnostic and Biomedical Sciences and The University of Texas Health Science Center at Houston, School of Dentistry, Houston, Texas, USA
| | - Mary C. Farach-Carson
- Department of Diagnostic and Biomedical Sciences and The University of Texas Health Science Center at Houston, School of Dentistry, Houston, Texas, USA
- Department of Biosciences and Rice University, Houston, Texas, USA
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | - Simon Young
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, School of Dentistry, Houston, Texas, USA
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Wu VWC, Ying MT, Kwong DL, Khong PL, Wong GK, Tam SY. A longitudinal study on parotid and submandibular gland changes assessed by magnetic resonance imaging and ultrasonography in post-radiotherapy nasopharyngeal cancer patients. BJR Open 2020; 2:20200003. [PMID: 33178971 PMCID: PMC7583169 DOI: 10.1259/bjro.20200003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 12/24/2022] Open
Abstract
Objectives With regard to the intensity modulated radiotherapy (IMRT) of nasopharyngeal carcinoma (NPC) patients, this longitudinal study evaluated the radiation-induced changes in the parotid and submandibular glands in terms of gland size, echogenicity and haemodynamic parameters. Methods 21 NPC patients treated by IMRT underwent MRI and ultrasound scans before radiotherapy, and at 6, 12, 18 and 24 months after treatment. Parotid and submandibular gland volumes were measured from the MRI images, whereas the parotid echogenicity and haemodynamic parameters including the resistive index, pulsatility index, peak systolic velocity and end diastolic velocity were evaluated by ultrasonography. Trend lines were plotted to show the pattern of changes. The correlations of gland doses and the post-RT changes were also studied. Results The volume of the parotid and submandibular glands demonstrated a significant drop from pre-RT to 6 months post-RT. The parotid gland changed from hyperechoic before RT to either isoechoic or hypoechoic after treatment. The resistive index and pulsatility index decreased from pre-RT to 6 month post-RT, then started to increase at 12 month time interval. Both peak systolic velocity and end diastolic velocity increased after 6 months post-RT then followed a decreasing trend up to 24 months post-RT. There was mild correlation between post-RT gland dose and gland volume, but not with haemodynamic changes. Conclusions Radiation from IMRT caused shrinkage of parotid and submandibular glands in NPC patients. It also changed the echogenicity and vascular condition of the parotid gland. The most significant changes were observed at 6 months after radiotherapy. Advances in knowledge It is the first paper that reports on the longitudinal changes of salivary gland volume, echogenicity and haemodynamic parameters altogether in NPC patients after radiotherapy. The results are useful for the prediction of glandular changes that is associated with xerostomia, which help to provide timely management of the complication when the patients attend follow-up visits.
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Affiliation(s)
- Vincent W C Wu
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Michael Tc Ying
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Dora Lw Kwong
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Pek-Lan Khong
- Department of Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Gary Kw Wong
- Department of Clinical Oncology, Queen Mary Hospital, Sha Tin, Hong Kong
| | - Shing-Yau Tam
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
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Experimental Animal Model Systems for Understanding Salivary Secretory Disorders. Int J Mol Sci 2020; 21:ijms21228423. [PMID: 33182571 PMCID: PMC7696548 DOI: 10.3390/ijms21228423] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/03/2020] [Accepted: 11/05/2020] [Indexed: 12/12/2022] Open
Abstract
Salivary secretory disorders are life-disrupting pathologic conditions with a high prevalence, especially in the geriatric population. Both patients and clinicians frequently feel helpless and get frustrated by the currently available therapeutic strategies, which consist mainly of palliative managements. Accordingly, to unravel the underlying mechanisms and to develop effective and curative strategies, several animal models have been developed and introduced. Experimental findings from these models have contributed to answer biological and biomedical questions. This review aims to provide various methodological considerations used for the examination of pathological fundamentals in salivary disorders using animal models and to summarize the obtained findings. The information provided in this review could provide plausible solutions for overcoming salivary disorders and also suggest purpose-specific experimental animal systems.
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Doppalapudi R, Vundavalli S, Prabhat MP. Effect of probiotic bacteria on oral Candida in head- and neck-radiotherapy patients: A randomized clinical trial. J Cancer Res Ther 2020; 16:470-477. [PMID: 32719253 DOI: 10.4103/jcrt.jcrt_334_18] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objective The aim of the study is to assess the effect of probiotic bacteria on oral Candida counts in cancer patients who are undergoing head- and neck-radiotherapy in a tertiary care center. Study Design The study was a randomized clinical trial including 90 patients who just completed head- and neck-radiotherapy. Materials and Methods Participants were randomly allocated into three equal sized groups, i.e., probiotics group, candid group, and combination groups. Oral rinse samples of the patients were collected before and after the intervention for the identification of Candida. The samples were incubated on Sabouraud's Dextrose Agar with Chloramphenicol at 37°C for 48 h, to assess the counts of colony-forming units/milliliter (CFU/ml) of Candida in saliva, and further on chrome agar plates to identify the Candida spp. Data were analyzed using mixed ANOVA to compare mean CFU/ml of Candida among three groups before and after the intervention. Results A total of 86 patients were included in the final analysis and there was a statistically significant reduction in mean Candida spp. Counts (CFU/ml) after intervention in all the three groups (P = 0.000) and significant reductions identified in both probiotic and combination therapy groups. Apart from reduction in Candida albicans, significant decrease in Candida glabrata and Candida tropicalis was observed after probiotics usage compared to other groups. Conclusions The present study suggests that probiotic bacteria were effective in reducing oral Candida spp which can be recommended alone or in combination with traditional antifungal agents for effective reduction in oral Candida in head- and neck-radiotherapy patients.
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Affiliation(s)
- Radhika Doppalapudi
- Department of Oral Radiology, College of Dentistry, Aljouf University, Sakaka, Kingdom of Saudi Arabia
| | - Sudhakar Vundavalli
- Department of Preventive Dentistry, College of Dentistry, Aljouf University, Sakaka, Kingdom of Saudi Arabia
| | - M P Prabhat
- Department of Oral Medicine and Radiology, Drs. S and NR Siddhartha Institute of Dental Sciences, Gannavaram, Andhra Pradesh, India
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Valstar MH, de Bakker BS, Steenbakkers RJHM, de Jong KH, Smit LA, Klein Nulent TJW, van Es RJJ, Hofland I, de Keizer B, Jasperse B, Balm AJM, van der Schaaf A, Langendijk JA, Smeele LE, Vogel WV. The tubarial salivary glands: A potential new organ at risk for radiotherapy. Radiother Oncol 2020; 154:292-298. [PMID: 32976871 DOI: 10.1016/j.radonc.2020.09.034] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The presence of previously unnoticed bilateral macroscopic salivary gland locations in the human nasopharynx was suspected after visualization by positron emission tomography/computed tomography with prostate-specific membrane antigen ligands (PSMA PET/CT). We aimed to elucidate the characteristics of this unknown entity and its potential clinical implications for radiotherapy. MATERIALS AND METHODS The presence and configuration of the PSMA-positive area was evaluated in a retrospective cohort of consecutively scanned patients with prostate or urethral gland cancer (n = 100). Morphological and histological characteristics were assessed in a human cadaver study (n = 2). The effect of radiotherapy (RT) on salivation and swallowing was retrospectively investigated using prospectively collected clinical data from a cohort of head-neck cancer patients (n = 723). With multivariable logistic regression analysis, the association between radiotherapy (RT) dose and xerostomia or dysphagia was evaluated. RESULTS All 100 patients demonstrated a demarcated bilateral PSMA-positive area (average length 4 cm). Histology and 3D reconstruction confirmed the presence of PSMA-expressing, predominantly mucous glands with multiple draining ducts, predominantly near the torus tubarius. In the head-neck cancer patients, the mean RT dose to the gland area was significantly associated with physician-rated post-treatment xerostomia and dysphagia ≥ grade 2 at 12 months (0.019/gy, 95%CI 0.005-0.033, p = .007; 0.016/gy, 95%CI 0.001-0.031, p = .036). Follow-up at 24 months had similar results. CONCLUSION The human body contains a pair of previously overlooked and clinically relevant macroscopic salivary gland locations, for which we propose the name tubarial glands. Sparing these glands in patients receiving RT may provide an opportunity to improve their quality of life.
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Affiliation(s)
- Matthijs H Valstar
- Dept. of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute (NCI), Amsterdam, the Netherlands; Dept. of Oral and Maxillofacial Surgery, Amsterdam UMC (AUMC), University of Amsterdam, Amsterdam, the Netherlands.
| | - Bernadette S de Bakker
- Dept. of Medical Biology, Section Clinical Anatomy & Embryology, AUMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Roel J H M Steenbakkers
- Dept. of Radiation Oncology, University of Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands
| | - Kees H de Jong
- Dept. of Medical Biology, Section Clinical Anatomy & Embryology, AUMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Laura A Smit
- Dept. of Pathology, NCI, Amsterdam, the Netherlands
| | - Thomas J W Klein Nulent
- Dept. of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center (UMCU), University Medical Center Utrecht, Utrecht, the Netherlands; Dept. of Oral and Maxillofacial Surgery, UMCU, Utrecht, the Netherlands
| | - Robert J J van Es
- Dept. of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center (UMCU), University Medical Center Utrecht, Utrecht, the Netherlands; Dept. of Oral and Maxillofacial Surgery, UMCU, Utrecht, the Netherlands
| | - Ingrid Hofland
- Core Facility Molecular Pathology & Biobanking, Division of Pathology, NCI, Amsterdam, the Netherlands
| | - Bart de Keizer
- Dept. of Radiology and Nuclear Medicine, UMCU, Utrecht, the Netherlands
| | - Bas Jasperse
- Dept. of Radiology, NCI, Amsterdam, the Netherlands
| | - Alfons J M Balm
- Dept. of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute (NCI), Amsterdam, the Netherlands; Dept. of Oral and Maxillofacial Surgery, Amsterdam UMC (AUMC), University of Amsterdam, Amsterdam, the Netherlands
| | - Arjen van der Schaaf
- Dept. of Radiation Oncology, University of Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands
| | - Johannes A Langendijk
- Dept. of Radiation Oncology, University of Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands
| | - Ludi E Smeele
- Dept. of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute (NCI), Amsterdam, the Netherlands; Dept. of Oral and Maxillofacial Surgery, Amsterdam UMC (AUMC), University of Amsterdam, Amsterdam, the Netherlands
| | - Wouter V Vogel
- Dept. of Nuclear Medicine, NCI, Amsterdam, the Netherlands; Dept. of Radiation Oncology, NCI, Amsterdam, the Netherlands
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Effect of photobiomodulation on salivary flow and composition, xerostomia and quality of life of patients during head and neck radiotherapy in short term follow-up: A randomized controlled clinical trial. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2020; 209:111933. [DOI: 10.1016/j.jphotobiol.2020.111933] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/01/2020] [Accepted: 06/10/2020] [Indexed: 11/23/2022]
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Bhandari S, Soni BW, Bahl A, Ghoshal S. Radiotherapy‐induced oral morbidities in head and neck cancer patients. SPECIAL CARE IN DENTISTRY 2020; 40:238-250. [DOI: 10.1111/scd.12469] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/14/2020] [Accepted: 04/22/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Sudhir Bhandari
- Unit of ProsthodonticsOral Health Sciences CentrePost Graduate Institute of Medical Education and Research Chandigarh India
| | - Bhavita Wadhwa Soni
- Unit of ProsthodonticsOral Health Sciences CentrePost Graduate Institute of Medical Education and Research Chandigarh India
| | - Amit Bahl
- Department of RadiotherapyPostgraduate Institute of Medical Education and Research Chandigarh India
| | - Sushmita Ghoshal
- Department of RadiotherapyPostgraduate Institute of Medical Education and Research Chandigarh India
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Lui SK, Neo SHS, Quah DSC. The Challenges Faced and Lessons Learnt in the Multidisciplinary Management of Medication Refractory Post-Stroke Sialorrhea: A Case Report. Cureus 2020; 12:e7978. [PMID: 32523835 PMCID: PMC7273414 DOI: 10.7759/cureus.7978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Post-stroke sialorrhea is a very debilitating condition that negatively impacts a person’s physical and psychological health. In this report, we discuss a case of medication refractory post-stroke sialorrhea in a female patient. The patient received multidisciplinary management and two fractions of radiotherapy over a course of five months. The treatment was successful, and the patient reported satisfactory control of her sialorrhea symptoms. We hope to highlight the importance of multidisciplinary management and consideration of radiotherapy as a treatment modality when providing care for medication refractory post-stroke sialorrhea patients who are unsuitable for salivary gland botulinum toxin (BoNT) injection and surgery.
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Affiliation(s)
- Siew Kwaon Lui
- Rehabilitation Medicine, Singapore General Hospital, Singapore, SGP
| | | | - Daniel Song Chiek Quah
- Radiation Oncology, National Cancer Centre, Singapore, SGP.,Supportive and Palliative Care, National Cancer Centre, Singapore, SGP
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Khan E, Farooq I, Khabeer A, Ali S, Zafar MS, Khurshid Z. Salivary gland tissue engineering to attain clinical benefits: a special report. Regen Med 2020; 15:1455-1461. [PMID: 32253995 DOI: 10.2217/rme-2019-0079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The salivary glands produce saliva, which helps in mediating the oral colonization of microbes, the repair of mucosa, the remineralization of teeth, lubrication and gustation. However, certain medications, therapeutic radiation and certain autoimmune diseases can cause a reduction in the salivary flow. The aim of this report was to review and highlight the indications and techniques of salivary gland engineering to counter hyposalivation. This report concludes that in the literature, numerous strategies have been suggested and discussed pertaining to the engineering of salivary gland, however, challenges remain in terms of its production and accurate function. Dedicated efforts are required from researchers all over the world to obtain the maximum benefits from salivary gland engineering techniques.
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Affiliation(s)
- Erum Khan
- CODE-M Center of Dental Education & Medicine, Karachi, Pakistan.,Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Imran Farooq
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdul Khabeer
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Saqib Ali
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madina Al Munawwarra, Saudi Arabia.,Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, Pakistan
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa, Saudi Arabia
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Morphology, Volume, and Density Characteristics of the Parotid Glands before and after Chemoradiation Therapy in Patients with Head and Neck Tumors. Int J Dent 2020; 2020:8176260. [PMID: 32377200 PMCID: PMC7195655 DOI: 10.1155/2020/8176260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/23/2020] [Accepted: 03/04/2020] [Indexed: 12/12/2022] Open
Abstract
The multimodal approach for patients with head and neck cancer (HNC) includes treatment with chemoradiation therapy (CRT). A common concern regarding CRT side effects is the occurrence of structural and physiological alterations of the salivary glands due to exposure to ionizing radiation. The aim of this study is to examine the morphology, volume, and density of the parotid glands before and after CRT in HNC patients. A total of 49 HNC patients treated exclusively with CRT were included in the study. Ninety-eight parotid glands were evaluated before and after treatment by using contrast-enhanced computed tomography (CECT). Shapiro-Wilk test was performed, and the variables (pre-CRT and post-CRT) presented normal distribution. Pearson's coefficient was used to assess the correlation between volume and density. CRT resulted in a significant decrease in the mean volume of the parotid glands (i.e., original volume reduced by 20.5%; P < 0.0001). CRT induced a 30.0% (7 Hounsfield units) increase in density of the right parotid gland and a 24.9% (8 Hounsfield units) increase in density of the left parotid gland (P=0.0198 and P=0.0079, respectively). Changes in morphology and spatial configuration, increased density, and substantial loss of volume of the parotid glands were observed after CRT. There was also a difference in density (P=0.003) in the right-side parotid glands in comparison between xerostomic and nonxerostomic groups of patients. These facts lead to the need for a personalized CRT planning in order to minimize oral complications related to the treatment.
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Diffusion-weighted imaging as a follow-up modality for evaluation of major salivary gland function in nasopharyngeal carcinoma patients: a preliminary study. Strahlenther Onkol 2020; 196:530-541. [PMID: 32025803 PMCID: PMC7248033 DOI: 10.1007/s00066-020-01580-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 01/07/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE To investigate the value of diffusion-weighted imaging (DWI) in assessing dynamic changes of major salivary gland function during follow-up post radiotherapy (RT) in nasopharyngeal carcinoma (NPC) patients. MATERIALS AND METHODS 31 consecutive patients with pathologically confirmed NPC scheduled for RT underwent six routine follow-up MRI examinations including DWI sequence prior to (pre-RT) and 1, 3, 6, 9, and 12 months post RT. Mean apparent diffusion coefficient (ADC) values of bilateral parotid glands (PGs) and submandibular glands (SMGs) were measured. Objective measurement of salivary flow rate (SFR) under unstimulated (uSFR) and stimulated conditions (sSFR) as well as subjective xerostomia assessment according to a patient-rated questionnaire were conducted before each MRI. Variance analysis was used to evaluate dynamic changes of ADC, SFR and xerostomia questionnaire summary scores (XQ-sum) at different timepoints and the correlation between ADC and XQ-sum. Pearson's correlation test was used to evaluate the correlations between pre- and post-RT changes of ADC (ΔADC) and SFR (ΔSFR) or mean RT dose. RESULTS At each timepoint, ADCs of PGs were significantly lower than of SMGs, uSFR was significantly lower than sSFR. For both PGs and SMGs, ADCpost-RT were all higher than ADCpre-RT, with significant differences. ADC1m-post-RT initially increased and changed little to ADC3m-post-RT, ADC6m-post-RT, ADC9m-post-RT, and ADC12m-post-RT, then gradually declined over time. The dynamic change trends of SFR were negatively paralleled to those of ADC, while that of XQ-sum was similar. Dose-response relationships were detected between salivary gland mean RT dose and ΔADC. In PGs, negative correlations between ΔsSFR9m-post-RT and ΔADC9m-post-RT, and ΔsSFR12m-post-RT and ΔADC12m-post-RT were detected. In SMGs, negative correlations between ΔsSFR12m-post-RT and ΔADC12m-post-RT, and ΔuSFR12m-post-RT and ΔADC12m-post-RT were also detected. The ADCs of patients with severe subjective xerostomia were significantly higher, while patients with moderate subjective xerostomia presented a tendency toward higher ADCs compared to those with mild xerostomia from 6 to 12 months post RT. CONCLUSION As part of routine follow-up MRI in NPC patients, DWI might be a promising modality for follow-up assessing the dynamic changes of major salivary gland function and might be more powerful in the late post-RT period.
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Rinstad T, Bergqvist B, Mattsson U. Follow‐up of need for dental treatment in 126 patients who have received radiation treatment to the head and neck region. Int J Dent Hyg 2019; 18:201-209. [DOI: 10.1111/idh.12426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 12/04/2019] [Accepted: 12/08/2019] [Indexed: 01/04/2023]
Affiliation(s)
- Tamara Rinstad
- Clinic of Orofacial Medicine/Hospital Dentistry Central Hospital Karlstad Sweden
| | - Birgitta Bergqvist
- Clinic of Orofacial Medicine/Hospital Dentistry Central Hospital Karlstad Sweden
| | - Ulf Mattsson
- Clinic of Orofacial Medicine/Hospital Dentistry Central Hospital Karlstad Sweden
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O'Keefe KJ, DeSantis KA, Altrieth AL, Nelson DA, Taroc EZM, Stabell AR, Pham MT, Larsen M. Regional Differences following Partial Salivary Gland Resection. J Dent Res 2019; 99:79-88. [PMID: 31765574 DOI: 10.1177/0022034519889026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Regenerative medicine aims to repair, replace, or restore function to tissues damaged by aging, disease, or injury. Partial organ resection is not only a common clinical approach in cancer therapy but also an experimental injury model used to examine mechanisms of regeneration and repair in organs. We performed a partial resection, or partial sialoadenectomy, in the female murine submandibular salivary gland (SMG) to establish a model for investigation of repair mechanisms in salivary glands (SGs). After partial sialoadenectomy, we performed whole-gland measurements over a period of 56 d and found that the gland increased slightly in size. We used microarray analysis and immunohistochemistry (IHC) to examine messenger RNA and protein changes in glands over time. Microarray analysis identified dynamic changes in the transcriptome 3 d after injury that were largely resolved by day 14. At the 3-d time point, we detected gene signatures for cell cycle regulation, inflammatory/repair response, and extracellular matrix (ECM) remodeling in the partially resected glands. Using quantitative IHC, we identified a transient proliferative response throughout the gland. Both secretory epithelial and stromal cells expressed Ki67 that was detectable at day 3 and largely resolved by day 14. IHC also revealed that while most of the gland underwent a wound-healing response that resolved by day 14, a small region of the gland showed an aberrant sustained fibrotic response characterized by increased levels of ECM deposition, sustained Ki67 levels in stromal cells, and a persistent M2 macrophage response through day 56. The partial submandibular salivary gland resection model provides an opportunity to examine a normal healing response and an aberrant fibrotic response within the same gland to uncover mechanisms that prevent wound healing and regeneration in mammals. Understanding regional differences in the wound-healing responses may ultimately affect regenerative therapies for patients.
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Affiliation(s)
- K J O'Keefe
- Molecular, Cellular, Developmental, and Neural Biology Graduate Program, State University of New York, University at Albany, Albany, NY, USA.,Department of Biological Sciences, State University of New York, University at Albany, Albany, NY, USA
| | - K A DeSantis
- Molecular, Cellular, Developmental, and Neural Biology Graduate Program, State University of New York, University at Albany, Albany, NY, USA.,Gen*NY*Sis Center for Excellence in Cancer, Department of Environmental Health Sciences, School of Public Health, State University of New York, University at Albany, Albany, NY, USA
| | - A L Altrieth
- Molecular, Cellular, Developmental, and Neural Biology Graduate Program, State University of New York, University at Albany, Albany, NY, USA.,Department of Biological Sciences, State University of New York, University at Albany, Albany, NY, USA
| | - D A Nelson
- Department of Biological Sciences, State University of New York, University at Albany, Albany, NY, USA
| | - E Z M Taroc
- Molecular, Cellular, Developmental, and Neural Biology Graduate Program, State University of New York, University at Albany, Albany, NY, USA.,Department of Biological Sciences, State University of New York, University at Albany, Albany, NY, USA
| | - A R Stabell
- Department of Biological Sciences, State University of New York, University at Albany, Albany, NY, USA.,Current address: Department of Developmental and Cell Biology, University of California, Irvine, Irvine, CA, USA
| | - M T Pham
- Department of Biological Sciences, State University of New York, University at Albany, Albany, NY, USA.,Current address: The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Campus, Midlothian, Scotland, UK
| | - M Larsen
- Molecular, Cellular, Developmental, and Neural Biology Graduate Program, State University of New York, University at Albany, Albany, NY, USA.,Department of Biological Sciences, State University of New York, University at Albany, Albany, NY, USA
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47
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Sousa AS, Silva JF, Pavesi VCS, Carvalho NA, Ribeiro-Júnior O, Varellis MLZ, Prates RA, Bussadori SK, Gonçalves MLL, Horliana ACRT, Deana AM. Photobiomodulation and salivary glands: a systematic review. Lasers Med Sci 2019; 35:777-788. [DOI: 10.1007/s10103-019-02914-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 10/30/2019] [Indexed: 12/14/2022]
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48
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Wu VWC, Leung KY. A Review on the Assessment of Radiation Induced Salivary Gland Damage After Radiotherapy. Front Oncol 2019; 9:1090. [PMID: 31750235 PMCID: PMC6843028 DOI: 10.3389/fonc.2019.01090] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/02/2019] [Indexed: 12/30/2022] Open
Abstract
Head and neck cancers are common in Southern China including Hong Kong. Intensity modulated radiotherapy has been the treatment of choice for these patients. Although radiotherapy provides good local control, radiotherapy treatment side-effects are still inevitable due to close proximity of the organs at risk from the target volume. Xerostomia, which is caused due to the damage of salivary glands, is one of the main radiation induced toxicities in post-radiotherapy head and neck patients. This review article discusses the methods for the assessing of radiation induced salivary gland changes including the gland morphology and saliva flow rate. The discussion also includes the recovery of the salivary gland after radiotherapy and how it is affected by the dose. It is expected that the future direction in monitoring the recovery of salivary glands will focus in cellular or molecular levels, and the development of imaging biomarker.
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Affiliation(s)
- Vincent W C Wu
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Kit Yee Leung
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong
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49
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Astaburuaga R, Gabryś HS, Sánchez-Nieto B, Floca RO, Klüter S, Schubert K, Hauswald H, Bangert M. Incorporation of Dosimetric Gradients and Parotid Gland Migration Into Xerostomia Prediction. Front Oncol 2019; 9:697. [PMID: 31417872 PMCID: PMC6684756 DOI: 10.3389/fonc.2019.00697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/15/2019] [Indexed: 12/23/2022] Open
Abstract
Purpose: Due to the sharp gradients of intensity-modulated radiotherapy (IMRT) dose distributions, treatment uncertainties may induce substantial deviations from the planned dose during irradiation. Here, we investigate if the planned mean dose to parotid glands in combination with the dose gradient and information about anatomical changes during the treatment improves xerostomia prediction in head and neck cancer patients. Materials and methods: Eighty eight patients were retrospectively analyzed. Three features of the contralateral parotid gland were studied in terms of their association with the outcome, i.e., grade ≥ 2 (G2) xerostomia between 6 months and 2 years after radiotherapy (RT): planned mean dose (MD), average lateral dose gradient (GRADX), and parotid gland migration toward medial (PGM). PGM was estimated using daily megavoltage computed tomography (MVCT) images. Three logistic regression models where analyzed: based on (1) MD only, (2) MD and GRADX, and (3) MD, GRADX, and PGM. Additionally, the cohort was stratified based on the median value of GRADX, and a univariate analysis was performed to study the association of the MD with the outcome for patients in low- and high-GRADX domains. Results: The planned MD failed to recognize G2 xerostomia patients (AUC = 0.57). By adding the information of GRADX (second model), the model performance increased to AUC = 0.72. The addition of PGM (third model) led to further improvement in the recognition of the outcome (AUC = 0.79). Remarkably, xerostomia patients in the low-GRADX domain were successfully identified (AUC = 0.88) by the MD alone. Conclusions: Our results indicate that GRADX and PGM, which together serve as a proxy of dosimetric changes, provide valuable information for xerostomia prediction.
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Affiliation(s)
- Rosario Astaburuaga
- Department of Medical Physics in Radiation Oncology, Deutsches Krebsforschungszentrum, Heidelberg, Germany.,Medical Faculty of Heidelberg, Universität Heidelberg, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany.,Institute of Physics, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Hubert S Gabryś
- Department of Medical Physics in Radiation Oncology, Deutsches Krebsforschungszentrum, Heidelberg, Germany.,Medical Faculty of Heidelberg, Universität Heidelberg, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany
| | | | - Ralf O Floca
- Heidelberg Institute for Radiation Oncology, Heidelberg, Germany.,Medical Image Computing, Deutsches Krebsforschungszentrum, Heidelberg, Germany.,Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | - Sebastian Klüter
- Heidelberg Institute for Radiation Oncology, Heidelberg, Germany.,Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | - Kai Schubert
- Heidelberg Institute for Radiation Oncology, Heidelberg, Germany.,Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | - Henrik Hauswald
- Heidelberg Institute for Radiation Oncology, Heidelberg, Germany.,Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Radiation Oncology, Deutsches Krebsforschungszentrum, Heidelberg, Germany
| | - Mark Bangert
- Department of Medical Physics in Radiation Oncology, Deutsches Krebsforschungszentrum, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany
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50
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Valstar MH, Owers EC, Al-Mamgani A, Smeele LE, van de Kamer JB, Sonke JJ, Vogel WV. Prostate-specific membrane antigen positron emission tomography/computed tomography as a potential tool to assess and guide salivary gland irradiation. PHYSICS & IMAGING IN RADIATION ONCOLOGY 2019; 9:65-68. [PMID: 33458427 PMCID: PMC7807566 DOI: 10.1016/j.phro.2019.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 02/15/2019] [Accepted: 02/19/2019] [Indexed: 11/28/2022]
Abstract
PSMA PET/CT allows visualisation of salivary glands with good spatial and contrast resolution. Evaluable glands include minor and less well-known gland locations. PSMA PET/CT can visualise damage to salivary glands from external beam radiotherapy. PSMA PET/CT has the potential to guide optimisation of radiotherapy to the head and neck. The potential benefit of PSMA PET/CT is to avoid salivary gland toxicity and preserve quality of life.
Evaluation of salivary gland damage after head and neck radiotherapy (RT) is difficult with current tools, such as subjective patient-reported outcome measures. We demonstrate the use of prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) as an objective non-invasive tool to visualize damage to salivary glands resulting from RT. In three clinical cases, the PSMA-ligand distribution correlates to the RT dose distribution including intra-gland dose gradients and matches patient-reported toxicity, suggesting a dose-response relation. These findings support further exploration of PSMA PET/CT to guide and evaluate RT, with the ultimate aim to reduce salivary gland toxicity.
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Affiliation(s)
- Matthijs H Valstar
- Department of Head and Neck Oncology and Surgery, Antoni van Leeuwenhoek The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Emilia C Owers
- Department of Nuclear Medicine, Antoni van Leeuwenhoek The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Abrahim Al-Mamgani
- Department of Radiation Oncology, Antoni van Leeuwenhoek The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Ludwig E Smeele
- Department of Head and Neck Oncology and Surgery, Antoni van Leeuwenhoek The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Jeroen B van de Kamer
- Department of Radiation Oncology, Antoni van Leeuwenhoek The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Jan-Jakob Sonke
- Department of Radiation Oncology, Antoni van Leeuwenhoek The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Wouter V Vogel
- Department of Nuclear Medicine, Antoni van Leeuwenhoek The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Department of Radiation Oncology, Antoni van Leeuwenhoek The Netherlands Cancer Institute, Amsterdam, the Netherlands
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