Effect of trehalose solution spray on post-radiation xerostomia related quality of life in head and neck cancer patients

Abstract

Radiotherapy is the standard treatment of head and neck cancer (HNC). The radiation may affect on normal tissue and surrounding salivary gland resulting to xerostomia. Treatment of radiation-related xerostomia focuses on relieving symptoms by using saliva substitutes or saliva stimulants. Because the salivary stimulants have significant side effects, such as sweating, dizziness or increasing urge to urinate, saliva substitutes are preferable. Trehalose solution has been suggested for improve moisture in dry mouth condition and can be used as saliva substitute. The purpose of this study is to evaluate the effectiveness of 10% Trehalose solution spray to improve dry mouth condition and quality of life (QoL) in post-radiotherapy HNC patients compared with carboxymethylcellulose (CMC) solution spray, which is commonly prescribed for dry mouth patients. Seventy post-radiotherapy patients diagnosed with HNC were included and randomly divided into two groups; to use CMC or Trehalose solution spray. Patients were interviewed with a Xerostomia-related Quality of Life scale (XeQoLs) questionnaire, and then instructed to use spray for two pumps (approximately 0.4 ml.), 4 times a day, after 3 meals and before bedtime. After 14 days of use, all participants were interviewed with the questionnaire again. Saliva was collected before and after use interventions 14 days for measurement of saliva volume and salivary pH. Patients significantly had better XeQoLs scores after use of either CMC or Trehalose solution spray in the aspect of physical, pain/discomfort, and psychological dimensions (P<0.05) but not social dimension (P>0.05). When compared between CMC and Treholose solution spray, the before-after intervention differences of XeQoLs scores were not significantly different (P>0.05). Salivary pH and saliva volume were significantly increased after use Trehalose solution spray (P<0.05), but not statistically significant increased after use CMC solution spray (P>0.05). In conclusion, Trehalose solution spray can effectively relieve post-radiation xerostomia leading to improve QoL of HNC patients comparable with CMC solution spray.