orabase and Head-and-Neck-Neoplasms

The aim of this study was to investigate the effect of trehalose oral spray to relieve radiation-induced xerostomia on a randomized controlled trial (RCT).. Prior to RCT, the effect of trehalose (5-20%) on the epithelial growth of fetal mouse salivary gland (SG) explants was evaluated to confirm if 10% trehalose exerted the best epithelial outcomes. Participants who completed radiotherapy for head and neck cancer (HNC) treatment were enrolled in a double-blind RCT, according to inclusion and exclusion criteria as per the CONSORT statement. The experimental group (n = 35) received 10% trehalose spray, while the control group (n = 35) received carboxymethylcellulose (CMC) spray to apply intra-orally 4 times/day for 14 days. Salivary pH and unstimulated salivary flow rate were recorded pre- and post-interventions. The Xerostomia-related Quality of Life scale (XeQoLs) was filled, and scores assessed post-interventions.. In the SG explant model, pro-acinar epithelial growth and mitosis was supported by 10% topical trehalose. As for RCT outcomes, salivary pH and unstimulated salivary flow rate were significantly improved after use of 10% trehalose spray when compared to CMC (p < 0.05). Participants reported an improvement of XeQoLs dimension scores after using trehalose or CMC oral sprays in terms of physical, pain/discomfort, and psychological dimensions (p < 0.05), but not social (p > 0.05). When comparing between CMC and trehalose sprays, XeQoLs total scores were not statistically different (p > 0.05).. The 10% trehalose spray improved salivary pH, unstimulated salivary flow rate, and the quality-of-life dimensions linked with physical, pain/discomfort, and psychological signs. The clinical efficacy of 10% trehalose spray was equivalent with CMC-based saliva substitutes for relieving radiation-induced xerostomia; therefore, trehalose may be suggested in alternative to CMC-based oral spray.(Thai Clinical Trials Registry; https://www.thaiclinicaltrials.org/ TCTR20190817004).

Topics: Carboxymethylcellulose Sodium; Head and Neck Neoplasms; Humans; Oral Sprays; Trehalose; Xerostomia

The effect of a linseed extract Salinum and a sodium carboxymethyl cellulose preparation called MAS-84 was compared with regard to its effect on the symptoms of dry mouth. Twenty patients with xerostomia, who had been treated for cancer in the head and neck by radiation were recruited from the clinic for maxillofacial surgery, Malmo University Hospital. Following radiation treatment the salivation was severely reduced. The symptoms of a general feeling of a dry mouth, difficulties in chewing and swallowing, taste disturbances, problems with speech and mouth burning were registered on a subjective verbal rating scale. In addition plaque index and gingival bleeding were determined. The study design was crossover and performed single blind. The experimental period was 7 weeks. The patients were randomly divided into 2 groups. One group used Salinum and the other MAS-84 for 3 weeks. The fourth week was a wash out period and for the next three weeks the patients shifted preparation. Each of the preparations was used ad libitum. Registrations of the various parameters were undertaken on days 0, 7 and 21 of the respective period. At the initial examination all patients reported considerable disturbances from mouth-dryness. These symptoms were reduced in 15 patients during the Salinum period and in 9 during the MAS-84 period. The relief was significantly more pronounced during the use of Salinum compared to that during the use of the methyl cellulose preparation. On day 21 plaque and gingival bleeding were significantly reduced during the Salinum period but not during the MAS-84 period. The results of the present study confirm those of a previous pilot study and indicate that the linseed mucilage significantly reduced the symptoms of dry mouth. This effect increased with increasing time of saliva substitute use. The linseed mucilage Salinum appeared to be a suitable saliva replacement in mouth dry patients.

Topics: Aged; Carboxymethylcellulose Sodium; Cranial Irradiation; Cross-Over Studies; Dental Plaque Index; Female; Head and Neck Neoplasms; Humans; Linseed Oil; Male; Middle Aged; Periodontal Index; Saliva, Artificial; Salivary Glands; Salivation; Secretory Rate; Single-Blind Method; Statistics, Nonparametric; Xerostomia

The effect of different artificial saliva formulations on biofilm activity and viability, and on enamel demineralization for head and neck cancer (HNC) patients was evaluated. Irradiated enamel samples were treated (1 min) with BioXtra® or with experimental formulations containing carboxymethylcellulose plus inorganic constituents alone (AS) or containing 0.1 mg mL

Topics: Anti-Bacterial Agents; Anti-Infective Agents; Biofilms; Carboxymethylcellulose Sodium; Chlorhexidine; Dental Caries; Head and Neck Neoplasms; Humans; Male; Phosphates; Saliva; Saliva, Artificial; Sucrose; Tooth Demineralization

The aim of this report was to describe the computed tomography features of injected carboxymethylcellulose and how it can be mistaken for tumor recurrence. Carboxymethylcellulose is a low-density injectable indicated for short-term vocal fold augmentation. When used in patients with head and neck cancer, differentiating this agent from a neoplastic recurrence can be difficult on imaging. The imaging findings of five patients who received carboxymethylcellulose augmentation are presented to illustrate a potential pitfall of image interpretation. When injectable carboxymethylcellulose is used in cancer patients, knowledge of the injection sites, material used, and procedural history can avoid misinterpretation of monitory imaging.

Topics: Aged; Carboxymethylcellulose Sodium; Female; Follow-Up Studies; Head and Neck Neoplasms; Humans; Injections; Laryngectomy; Laryngoplasty; Male; Middle Aged; Tomography, X-Ray Computed; Vocal Cord Paralysis; Vocal Cords; Voice Quality

Radiation treatment of scalp malignancies can be a challenge due to the multiple curved surfaces to which homogenous dose must be delivered. The most readily available techniques utilize linear accelerator-based technique of opposed lateral electron field abutting opposed lateral photon field with central blocking. Bolus material is used to achieve adequate skin dose. Although plans to add bolus material often occur in the virtual setting during treatment planning, the practical aspects of reproducibly maintain the bolus material along curved surfaces during the day-to-day patient setup can be a challenge. We present a case of a patient with squamous cell carcinoma of the scalp with neck node involvement treated with surgery followed by adjuvant radiotherapy. We demonstrate a unique immobilization technique that maintains the bolus material on the aquaplast mesh adherent to the patient's scalp as well as the neck. TomoTherapy with daily megavoltage computed tomography (CT) scan was utilized to verify the daily bolus position. We were able to maintain a 95% reproducibility rate. This technique reliably maintains the bolus material on the desired locations with minimum adjustments and manipulation by the therapist and is a technique that can be universally adaptable for conventional radiotherapy or intensity modulated radiation therapy (IMRT) techniques.

Topics: Carboxymethylcellulose Sodium; Carcinoma, Squamous Cell; Head and Neck Neoplasms; Humans; Immobilization; Male; Middle Aged; Radiotherapy Dosage; Reproducibility of Results; Scalp; Sensitivity and Specificity; Skin Neoplasms

Irregular facial contours can make radiation therapy of head and neck tumors difficult. Isodose lines become skewed, making treatment planning complex. A traditional solution to this problem is the paraffin wax box bolus. Such a bolus is made to fit the irregular surface compensating for the topology and creating an even surface. The fabrication of a wax bolus can be a difficult and time-consuming process. A method that is simple and efficient has been devised. Super Stuff bolus can be easily molded and has approximately the same effect as a similar paraffin wax bolus. This was verified by irradiating a Rando head phantom with both a paraffin wax bolus and a Super Stuff bolus. Doses to various points of interest were measured with thermoluminescent dosimetry (TLD) chips (LiF). The particular case addressed is malignant melanoma of the nasal septum, but the technique described can be useful in the treatment of other sites as well.

Topics: Carboxymethylcellulose Sodium; Face; Head and Neck Neoplasms; Humans; Melanoma; Nasal Septum; Nose Neoplasms; Paraffin; Phantoms, Imaging; Radiotherapy Dosage; Radiotherapy, Computer-Assisted; Radiotherapy, High-Energy; Surface Properties; Thermoluminescent Dosimetry; Waxes

An aquaplast mask/marker immobilization system for the routine radiation therapy treatment of head and neck disease is described. The system utilizes a commercially available thermoplastic mesh indexed and mounted to a rigid frame attached to the therapy couch. The apparatus is designed to permit CT, MRI, and PET diagnostic scans of the patient to be performed in the simulation and treatment position utilizing the same mask, thereby facilitating image correlation. Studies employing weekly simulation indicate that patient treatment position movement can be restricted to 3 mm over the course of treatment. This easily constructed system permits rapid mask formation to be performed on the treatment simulator, resulting in an immobilization device comparable to masks produced with vacuum-forming techniques. Details of construction, verification, and central axis CT, MRI, PET markers are offered.

Topics: Carboxymethylcellulose Sodium; Head and Neck Neoplasms; Humans; Immobilization; Magnetic Resonance Imaging; Radiotherapy Planning, Computer-Assisted; Radiotherapy, High-Energy; Technology, Radiologic; Tomography, Emission-Computed; Tomography, X-Ray Computed