The Effects of an Integrated Supportive Programme on Xerostomia and Salivary Characteristics in Patients With Head and Neck Cancer Undergoing Radiotherapy: a Randomized Controlled Trial

Abstract Aim: This study evaluates the effect of an integrated supportive programme on xerostomia and saliva characteristics at a one-year follow-up of patients with head and neck cancer (HNC) undergoing radiotherapy (RT).Methods: Participants were randomly allocated to an intervention group (n=47) or a control group (n=45). The intervention group received usual care and an integrated supportive programme, which included three steps: face-to-face education; face-to-face coaching at one-month post RT; and four telephone coaching sessions at 2-, 3-, 6-, and 9-months post RT. The face-to-face education consisted of oral hygiene instruction, oral self-care strategies, facial and tongue muscle exercises, and salivary gland massage. Adherence to the intervention was evaluated using a questionnaire completed during the nine-month follow-up. The control group received usual care. The unstimulated saliva flow rate, saliva pH, buffering capacity, and xerostomia were assessed in both groups.Results: A total of 79 participants (40 in the intervention group and 39 in the control group) completed the 12-month follow-up. There were statistically significant differences between the groups in level of xerostomia at the 3- and 12-month follow-up (P=0.027 and P<0.001, respectively) and in the mean value of unstimulated saliva flow rate at the 12-month follow-up (P=0.035), with better outcome in the intervention group. The adherence of the intervention was good but decreased slightly during the follow-up. Conclusion: This integrated supportive programme with good adherence relieved xerostomia and had a positive effect on unstimulated saliva flow rate among patients with HNC during the 12-month follow-up.