Sparing the region of the salivary gland containing stem cells preserves saliva production after radiotherapy for head and neck cancer

Peter van Luijk*, Sarah Pringle, Joseph O. Deasy, Vitali V. Moiseenko, Hette Faber, Allan Hovan, Mirjam Baanstra, Hans P. van der Laan, Roel G. J. Kierkels, Arjen van der Schaaf, Max J. Witjes, Jacobus M. Schippers, Sytze Brandenburg, Johannes A. Langendijk, Jonn Wu, Robert P. Coppes

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

123 Citations (Scopus)


Each year, 500,000 patients are treated with radiotherapy for head and neck cancer, resulting in relatively high survival rates. However, in 40% of patients, quality of life is severely compromised because of radiation-induced impairment of salivary gland function and consequent xerostomia (dry mouth). New radiation treatment technologies enable sparing of parts of the salivary glands. We have determined the parts of themajor salivary gland, the parotid gland, that need to be spared to ensure that the gland continues to produce saliva after irradiation treatment. In mice, rats, and humans, we showed that stem and progenitor cells reside in the region of the parotid gland containing the major ducts. We demonstrated in rats that inclusion of the ducts in the radiation field led to loss of regenerative capacity, resulting in long-term gland dysfunction with reduced saliva production. Then we showed in a cohort of patients with head and neck cancer that the radiation dose to the region of the salivary gland containing the stem/progenitor cells predicted the function of the salivary glands one year after radiotherapy. Finally, we showed that this region of the salivary gland could be spared during radiotherapy, thus reducing the risk of post-radiotherapy xerostomia.

Original languageEnglish
Article number305ra147
Number of pages8
JournalScience Translational Medicine
Issue number305
Publication statusPublished - 16-Sep-2015



Cite this