The Effectiveness Chewing gum versus Cryotherapy on Salivary Volume among Patient with Head and Neck Cancer undergoing Radiotherapy
Downloads
Introduction: Hyposalivation is a common problem experienced by head and neck (H&N) cancer patients undergoing radiotherapy. Hyposalivation can cause negative effects on the physical aspects of making oral mucositis, pain during eating and talking as well as psychological effects that cause feeling of discomfort sadness and, ultimately, depression. Many nonpharmacological interventions can be done for hyposalivation that occur in patients, among which are chewing gum and cryotherapy because they are easy to do, easy to access, inexpensive and have minimal side effects. However, the effectiveness of these interventions is not yet clear. Hence, this study is aimed to determine the effectiveness of chewing gum versus cryotherapy to increase salivary volume in H&N cancer patients undergoing radiotherapy.
Methods: A quasi-experimental time series group design to determine the most effective time to influence the increase in salivary volume. This research was conducted on 36 respondents H&N cancer undergoing radiotherapy with four times measurement are pretest-posttest on the 3rd, 5th, and 7th day of intervention between February and March 2020. Subjects were chosen using consecutive sampling. Chewing gum group will chew gum six (6) pieces/day and cryotherapy group will suck on ice cubes five (5) minutes before and after radiotherapy. The spitting method was used to collect saliva and the data were analyzed using General Linear Model-Repeated Measure (GLMRM).
Results: Chewing gum is more effective to increase salivary volume than cryotherapy. The GLMRM within subjects at four (4) times measurement showed a significant difference between chewing gum and cryotherapy group with p value <0.05 on the 7th day. Subjects in the chewing gum group had better salivary volume increment than cryotherapy group.
Conclusion: This study showed that chewing gum is more effective to increase salivary volume on patient H&N cancer undergoing radiotherapy because chewing gum has higher salivary volume increment than cryotherapy groups
Ambudkar, I. S. (2014). Ca2+ signaling and regulation of fluid secretion in salivary gland acinar cells. Cell Calcium, 1–9. https://doi.org/10.1016/j.ceca.2014.02.009
Baird, S. B., Donehower, M. G., Stalsbroten, V. L., & Ades, T. B. (1991). A cancer Source Book for Nurses (6th ed.). American Cancer Society.
Costa, E. M., Fernandes, M. Z., Quinder, L. B., De Souza, L. B., & Pinto, L. P. (2003). Evaluation of an oral preventive protocol in children with acute lymphoblastic leukemia. Pesquisa Odontologica Brasileira, 17(2), 147–150.
Dental, A., & Ada, A. (2015). Managing dry mouth. The Journal of the American Dental Association, 146(2), A40. https://doi.org/10.1016/j.adaj.2014.11.019
Didem, A., Ayfer, E., & Ferda, O. A. (2014). The Effect of Chewing Gum on Oral Mucositis in Children Receiving Chemotherapy. Health Science Journal, 8(3), 373–382.
Eghbali, Aziz., Taherkhanch., Bagheri B., S. S. (2017). Effect of Chewing Gum on Oral Mucositis in Children Undergoing Chemotherapy : A Randomized Controlled Study Original Article Effect of Chewing Gum on Oral Mucositis in Children Undergoing Chemotherapy : A Randomized Controlled Study. March 2016.
Epstein, J. B., Bensadoun, R., Saunders, D. P., & Rajesh, V. (2017). Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis. Cancer Medicine, 1–14. https://doi.org/10.1002/cam4.1221
Irna, & Subita, G. P. S. (2008). Identifikasi dan Pengendalian Faktor Risiko Mukositis Oral selama Radioterapi Kanker Nasofaring Laporan Kasus. Indonesian Journal of Dentistry, 15(4), 155–162.
Jernigan, A. M., Chiung, C., Chen, G., & Sewell, C. (2014). International Journal of Gynecology and Obstetrics CLINICAL ARTICLE A randomized trial of chewing gum to prevent postoperative ileus after laparotomy for benign gynecologic surgery ☆. International Journal of Gynecology and Obstetrics, 8–11. https://doi.org/10.1016/j.ijgo.2014.06.008
Kaae, J. K., Stenfeldt, L., & Eriksen, J. G. (2016). Xerostomia after radiotherapy fo r Oral and Oropharyngeal cancer: increasing salivary Flow with Tasteless sugar-free chewing gum. Frontiers in Oncology, 6(May), 1–6. https://doi.org/10.3389/fonc.2016.00111
Katranc, N., Ovayolu, N., Ovayolu, O., & Sevinc, A. (2012). European Journal of Oncology Nursing Evaluation of the effect of cryotherapy in preventing oral mucositis associated with chemotherapy e A randomized controlled trial. 16, 339–344. https://doi.org/10.1016/j.ejon.2011.07.008
Laursen, M., Specht, L., Kristensen, C. A., & Gothelf, A. (2018). An Extended Hypofractionated Palliative Radiotherapy Regimen for Head and Neck Carcinomas. 8(June), 1–8. https://doi.org/10.3389/fonc.2018.00206
Llop, M. R., Jimeno, F. G., Acien, R, M., & Dalmau, L. J. B. (2010). Effect of xylitol chewing gum on salivary flow rate, ph, buffering capacity and presence of Streptococcus mutans in saliva. European Journal of Paediatric Dentistry, 11(1), 9–14.
Marinna, A., & Harijanti, K. (2017). Management of Xerostomia post Radiotherapy Nasopharingeal Carcinoma: Case Report (Y. Septorini, Wimardhani, H. Ruslijanto, H. Djuaeni, I. Sufiyawati, T. Setiani, & A. F. Irawan (eds.)).
NIH. (2019). Salivary Gland Cancer Treatment (Adult). National Cancer Institute.
Pereira, J. V, Maciel, R. P., Jorge, M., & Monteiro, F. (2016). Effect of Chewing Gum Containing CPP-ACP on Salivary Flow and Buffer Capacity : An in vivo Study. 16((1)), 425–431.
Plemons, J. M., Al-hashimi, I., & Marek, C. L. (2014). Managing xerostomia and salivary gland hypofunction Executive. The Journal of the American Dental Association, 145(8), 867–873. https://doi.org/10.14219/jada.2014.44
Ra'abung, A. S., Sudiana, I. K., & Hidayati, L. (2019). Pengaruh mouthwash disertai mengunyah permen karet xylitol terhadap xerostomia, laju aliran saliva, dan pH saliva pada pasien yang menjalani hemodialisis. Universitas Airlangga.
Rodian, M., Satari, M. H., & Rolleta, E. (2011). Efek Mengunyah Permen karet yang Mengandung Sukrosa, Xylitol, Probiotik terhadap Volume, Kecepatan Aliran, Viskositas, pH, dan Jumlah Koloni Streptococcuc Mutans Saliva.
Rosdahl, C. B., & Kowalski, M. T. (2014). Text Book of Basic Nursing Edisi 10 (E. A. Mardella (ed.); 10th ed., p. 871). Lippincott Williams & Wilkins/Wolter Kluwer Health.
Samuels, M. A. (2017). Radiation-induced Oral Mucositis. 7(May). https://doi.org/10.3389/fonc.2017.00089
Santoso, B. S., Surarso, B., & Kentjono, W. A. (2009). Radioterapi pada Karsinoma Nasofaring. THT KL, 2(3), 134–141.
Siddiqui, F., & Movsas, B. (2017). Management of Radiation Toxicity in Head and Neck Cancer. Seminars in Radiation Oncology, 27(4), 340–349. https://doi.org/10.1016/j.semradonc.2017.04.008
Simíµes, A., Campos, L. De, Arana-chavez, V. E., & Nicolau, J. (2015). Low Level Laser Therapy for hyposalivation and xerostomia. 335–339.
Subramaniam, N., & Muthukrishnan, A. (2019). Oral mucositis and microbial colonization in oral cancer patients undergoing radiotherapy and chemotherapy : A prospective analysis in a tertiary care dental hospital. July, 1–6. https://doi.org/10.1111/jicd.12454
Surjadi, N., & Amtha, R. (2012). Radiotherapy Reduced Salivary Flow Rate and Might Induced C . albicans Infection. 19(1), 1–6.
Traktama, D. O., & Sufiawati, I. (2018). Keparahan mukositis oral pada pasien kanker kepala leher akibat kemoterapi dan / atau radioterapi. 4(1).
Utami, K. C. (2017). Mukositis Oral sebagai Dampak Kemoterapi pada Anak Kanker yang Mendapat Kemoterapi.
Utami, K. C., & Hayati, H. (2018). Chewing gum is more effective than saline-solution gargling for reducing oral mucositis. Enfermería Clínica, 28, 5–8. https://doi.org/10.1016/S1130-8621(18)30026-3
Villa, A., & Sonis, S. T. (2015). Mucositis : pathobiology and management. 159–164. https://doi.org/10.1097/CCO.0000000000000180
Yunus, B. (2008). Efek samping terapi radiasi penderita kanker kepala dan leher pada kelenjar saliva. 7(1), 57–62.
Authors who publish with Jurnal Ners agree to the following terms:
- Authors transfer the Copyright and grant Jurnal Ners the right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License that allows others to remix, adapt and build upon the work with an acknowledgment of the work's authorship and of the initial publication in Jurnal Ners.
- Authors are permitted to copy and redistribute the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Jurnal Ners.
Jurnal Ners requires a formal written declaration and transfer of copyright from the author(s) for each article published. We, therefore, ask you to complete and return this form, retaining a copy for your own records. Your cooperation is essential and appreciated. Any delay will result in a delay in publication. The form can be downloaded HERE.
