Prospective Phase II Study of the Efficacy of Transcutaneous Electrical Nerve Stimulation in Post-radiation Patients

摘要

Aims: To evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) delivered using an extra-oral device in patients with radiation-induced xerostomia. Materials and methods: Thirty oral cavity and oropharyngeal cancer patients post-adjuvant (. n=26) or definitive radiotherapy (. n=4) were enrolled in this study. The TENS electrode pads were placed externally on the skin overlying the parotid glands. Unstimulated whole saliva was collected for 5min into graduated tubes using the low forced spitting method. The TENS unit was then activated and stimulated saliva was collected for an additional 5min. The difference between unstimulated and stimulated saliva output was measured using the paired t-test. Linear regression was used to determine factors significantly influencing the improvement in salivary output. Results: Twenty-nine of 30 patients showed increased saliva flow during stimulation. A statistically significant improvement in saliva production (. P<0.05) during stimulation was noted. The mean unstimulated saliva flow was 0.056ml/min and the mean stimulated saliva flow was 0.12ml/min with a median increase of 0.06ml/min. The interval to the application of TENS after radiotherapy significantly influenced the improvement in salivary flow. Conclusion: Extra-oral application of TENS is effective in increasing the whole salivary flow in most of the post-radiated oral cavity/oropharyngeal cancer patients with xerostomia. TENS therapy may be useful as an effective supportive treatment modality in post-radiated oral cancer patients.