Radiotherapy changes salivary properties and impacts quality of life of children with Hodgkin disease

- There are limited evidence of effects of radiotherapy in children with Hodgkin's disease.
- We investigated the radiotherapy effects on salivary properties and quality of life.
- Radiotherapy increased the concentration of lactoferrin, mucin and IgA in saliva.
- Radiotherapy reduced the salivary flow rate and buffer capacity.
- Worse quality of life of children (xerostomia/oral pain) was associated with salivary changes.

ObjectiveWe aimed to perform a longitudinal investigation of the effects of radiotherapy on salivary flow rate, pH, buffering capacity, and protein composition of saliva and on the quality of life of children with Hodgkin disease.DesignTen children (6-16-year-old) with Hodgkin disease and 10 matched healthy children were investigated. Stimulated and non-stimulated saliva samples were collected at baseline, after 1080 and 2160 cGy of radiation, and 1, 2, and 3 months post-radiotherapy. The salivary flow rate was expressed as mL/min. Buffer capacity was determined by titration. Amylase activity, immunoglobulin A, mucin, and lactoferrin concentrations were determined by ELISA. Quality of life was assessed by Quality of Life - Head and Neck module 35 questionnaire.ResultsWe found that radiotherapy caused hyposalivation at 1080 cGy and 1 month after radiotherapy and reduced buffering capacity at 2160 cGy. Mucin concentration and amylase activity in non-stimulated saliva increased 1 month after radiotherapy. Lactoferrin concentration increased during and after radiotherapy. Immunoglobulin A concentration increased at 1080 cGy, 1 and 2 months, for non-stimulated saliva and at 2160 cGy and 1 month for stimulated saliva. Children reported more pain after radiotherapy and more xerostomia during radiotherapy.ConclusionWe concluded that the radiotherapy protocol affected the children's salivary properties and children's quality of life.