Radiation Induced Xerostomia in Head and Neck Cancer Survivors: A Qualitative Study

Introduction: Patients receiving radiation therapy (RT) for head and neck cancers often experience xerostomia, leading to oral discomfort and pain, an increased risk of dental caries and oral infections, as well as difficulties with speaking and swallowing. These issues severely impact quality of life (QOL) and can hinder nutritional intake and the ongoing administration of cancer treatment. The purpose of this work was to explore the head and neck patient’s experience of xerostomia after radiotherapy and its impact on quality of life. Material and Methods: We conducted a descriptive qualitative study with a sample of 65 patients treated by RT for HNC in a curative intent (Total dose 60 ≥ Gy), at least 6 months earlier and actually without evidence of disease. All patients completed a xerostomia questionnaire consisting of three parts (xerostomia score, quality of life survey, and visual analogue scale). Results: A high proportion of patients (94%) experienced dry mouth, with 61,5% presenting moderate to severe xerostomia (graded 2–3). Dysphagia (47%) and taste impairment (63%) were prevalent, whereas oral pain was reported in only 12% of cases. Xerostomia also had notable emotional consequences, triggering worry (58%), tension (52%), or depressive feelings (37%). Additionally, patients described difficulties in communicating (63%) and sharing meals (57%) with others, with 73% reporting limitations in food quantity and variety. Quality of life reductions were significantly correlated with elevated radiation doses, or concurrent chemotherapy administration. Conclusion: Radiation-induced xerostomia is often a permanent condition that significantly affects the patient's well-being. Concurrent chemotherapy may worsen radiation-induced oral complications. These findings highlight the urgent need to develop innovative radiation therapy (RT) techniques that spare salivary glands and prioritize targeted therapies to reduce radiation-induced dry mouth.