Amifostine may relieve symptoms of salivary gland dysfunction in head and neck cancer patients

 

Problems with saliva production and salivary glands are a significant and mostly permanent side effect for people after radiotherapy treatment to the head and neck. When this occurs the condition is known as dry mouth or xerostomia. Dry mouth is not measurable and is a subjective or personal expression of how the mouth feels. It can have other causes and is a consequence of the production of less saliva or by the consistency of saliva. The rate of flow of saliva in an individual’s mouth however can be measured. People who have dry mouth have a reduced quality of life. They can experience issues with taste and general discomfort, difficulties chewing, swallowing and speaking as well as tooth decay, thrush and other infections of the mouth. A wide range of drugs that work in different ways have been used to try and prevent problems with salivary glands caused by radiotherapy. Unfortunately there is currently not enough evidence to show which drugs or which type of drugs are most effective. Continue reading

EGFR mAb shows promising results for the treatment of oral cancer

OLYMPUS DIGITAL CAMERAOral cancers (cancer of the mouth and cancer of the throat) are the sixth most common cancer worldwide, accounting for an estimated 4% of all cancers. There is a higher frequency of these cancers in men. Smoking, alcohol consumption and betel quid chewing are the main risk factors. Cancer of the throat is associated with infection from the human papilloma virus (HPV), which can be transmitted through sexual contact. Low socioeconomic status (a measure of a person’s income, education and occupation in relation to other people’s) is associated with a higher frequency of oral cancers and poorer survival rates. Survival following a diagnosis of mouth or throat cancer remains poor, with around 50% of people still alive at five years (five-year survival rate).

New therapies targeted at the cells that give rise to oral cancers are being developed. The advantage these may have over conventional chemotherapy is that rather than affecting both healthy and cancerous cells they just target cancer cells. Immunotherapy (also known as biological therapy, biotherapy or biological response modifier therapy) may improve the functioning of the immune system so it is more effective at destroying cancer cells. Local immunotherapy delivers treatment directly into the tumour and systemic immunotherapy targets the whole body, and may be useful for stopping the cancer spreading or the return of primary tumours in more advanced cancer. Continue reading

Cochrane resources on mouth cancer

shutterstock_163829423November is Mouth Cancer Action Month, and the Cochrane Oral Health Group has a range of systematic reviews dedicated to the topic. Mouth cancer can affect anybody; in the UK more than 6,700 people were diagnosed with the condition last year, and more than 2,000 people died from the disease, more than testicular and cervical cancer combined. Here’s what the evidence says… Continue reading

Three new titles registered by the Oral Health Group

acupuncture needles

Acupuncture is one of the options for preventing gag reflex, but how effective is it compared to other interventions? A new Cochrane review will consider the evidence. Photo published under GNU Free Documentation License.

The Cochrane Oral Health Group‘s editorial team met last week to consider which new titles to register. OHG have had a number of submissions over the last six months, and three titles have been registered by the Group. The editors identified them as priority topics, and agreed that they did not significantly overlap with any existing reviews:

Interventions for the prevention of osteoradionecrosis of the jaws in patients receiving head and neck radiotherapy

This review will be led by Dr. Amri Azarpazhooh from the University of Toronto in Canada. He will be joined on the team by Dr. Michael Duchnay, Dr. Grace Bradley, Dr. Howard Tenenbaum, Dr. Prakeshkumar S. Shah and Dr. Hamid Reza Raziee, who are all also based at the University of Toronto.

Prevention of gag reflex for patients undergoing dental treatment

Dr. Eachempati Prashanti from Melaka-Manipal Medical College in Malaysia will lead this new review. Dr. P. Renjith George, Professor Nagraj Sumanth Kumargere, Dr. Laxminarayan Karanth and Dr. Htoo Htoo Kyaw Soe will also be on the on the author team.

Autologous platelet concentrates for regeneration of periodontal defects

This review will be a collaboration between authors based in Italy and India. Dr. Massimo Del Fabbro from Università degli Studi di Milano leads the team, his colleagues Dr. Valentina Ceresoli and Dr. Caterina Ceci will join him as authors. Dr. Silvio Taschieri from University of Milan IRCCS Galazzi Orthopaedic Institute is also an author. The author team is completed by Dr. Saurav Panda, Professor Sheeja Varghese, Professor Malaiappa Sankari, Professor N. D. Jayakumar and Dr. Surenda Ramamoorthi from Saveetha University, India.

We look forward to publishing the protocols in the near future, watch this space!

New publications from the Oral Health Group in the Cochrane Library, 2013, Issue 2

200Issue 2 of the Cochrane Library for 2013 was released today, and features one new review and three new protocols from the Oral Health Group.

We now have a total of 200 published systematic reviews and protocols on the Library, congratulations to all of our authors, editors and referees on this fantastic achievement!

New review:
Dental extractions prior to radiotherapy to the jaws for reducing post-radiotherapy dental complications
by Shiyana Eliyas, Ahmed Al-Khayatt, Richard WJ Porter, Peter Briggs

This new review aimed to assess the effects of maintaining the patient’s natural dentition during radiotherapy in comparison to extracting teeth before radiotherapy in areas that are difficult to access by the patient and the dentist, should reduction in mouth opening occur after radiotherapy to the jaws. No clinical trials were identified, and there is no high quality evidence on this clinically important topic.

New protocol:
Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy
by Kelvin KW Chan, Anne-Marie Glenny, Susan Furness, Helen V Worthington

This review is the fourth in a series of Cochrane reviews looking at different treatment modalities for oral cavity and oropharyngeal cancers: surgical treatment, chemotherapy and radiotherapy. There is a great deal of current research into new therapies for cancer and many of these make the headlines in the news. However, there is a significant time lag between laboratory discoveries and the introduction of new treatments into clinical care. This review will evaluate the randomised controlled trials of targeted and immunological therapies for patients with oral cavity or oropharyngeal cancer.

New protocol:
Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients
by Dimitrios Kloukos, Piotr Fudalej, Patrick Sequeira-Byron, Christos Katsaros

The conventional orthognathic surgery for correction of maxillary retrusion/hypoplasia is a Le Fort I osteotomy. Distraction osteogenesis is the surgical process of correction of skeletal deformity utilizing bone lengthening by gradual mechanical distraction. This review will compare the effectiveness of the two methods in patients with orofacial clefts.

New protocol:
Professionally-applied chemically-induced whitening of teeth in adults
by Alonso Carrasco-Labra, Romina Brignardello-Petersen, Nicolás Yanine, Ignacio Araya, Gabriel Rada, R Graham Chadwick

Professionally-applied bleaching treatments have been used for a long time. Despite all of the information available, it is difficult for clinicians to determine which is the most effective treatment for tooth discolouration and the level of potential harms of these treatments. This review aims to assess the evidence about the beneficial and adverse effects of in-office, professionally-applied chemically-induced whitening of teeth in adult patients. It will complement another Cochrane systematic review of the evidence for the use of home-based treatment methods.