Ricerc@Sapienza

Nowadays, surgery, radiation therapy (RT), chemotherapy or combinations of these therapeutic modalities represent the classical options for managing head and neck cancer (HNC). Primary definitive RT is usually performed in case of surgical approaches related to significant functional loss or in patients with medical contraindication to surgery. Due to the anatomic proximity to various structures, the risk of radiation-induced toxicities is important and imposes an adequate assessment, support and surveillance before, during and after treatment. Xerostomia represents the most common RT side effect. With the shift from a three dimensional technique to intensity modulated technology, interpretation of the clinical significance of the xerostomia identified in HNC has become a challenge. In the last decades, various clinical studies searching for predictors of radiation-induced xerostomia have been conducted and the vast majority of these trials focused on factors following parotid-sparing irradiation. One important consequence is that the spared glands in each patient is expected to produce the majority of saliva after RT. Anyway, after RT, parotid glands are damaged, thus their secretion is decreased and their secretory components are altered. Salivary amylase is a glucose-polymer cleavage enzyme mainly produced by parotid glands and it has a major physiologic role in food digestion. Its level can be easily measured in blood sample. A rise in serum salivary amylase seems to be strictly related to the quantity of salivary tissue exposed to ionizing radiation. Our aim is to explore the existence of a direct relationship between the serum salivary amylase rise and development of xerostomia after treatment. It may be useful in assessing the degree of radiation-induced damage.