Abstract
Background Radiation-associated soft tissue injury is a potentially devastating complication
for head and neck cancer patients. The damage can range from minor sequelae such as
xerostomia, which requires frequent daily maintenance, to destructive degenerative
processes such as osteoradionecrosis, which can contribute to flap failure and delay
or reverse oral rehabilitation. Despite the need for effective radioprotectants, the
literature remains sparse, primarily focused on interventions beyond the surgeon's
control, such as maintenance of good oral hygiene or modulation of radiation dose.
Methods This narrative review aggregates and explores noninvasive, systemic treatment modalities
for prevention or amelioration of radiation-associated soft tissue injury.
Results We highlighted nine modalities with the most clinical potential, which include amifostine,
melatonin, palifermin, hyperbaric oxygen therapy, photobiomodulation, pentoxifylline–tocopherol–clodronate,
pravastatin, transforming growth factor-β modulators, and deferoxamine, and reviewed
the benefits and limitations of each modality. Unfortunately, none of these modalities
are supported by strong evidence for prophylaxis against radiation-associated soft
tissue injury.
Conclusion While we cannot endorse any of these nine modalities for immediate clinical use,
they may prove fruitful areas for further investigation.
Keywords
radiation injury - head and neck cancer - prophylactic
