Xerostomia, or dry mouth, is a common side effect of head/neck radiation. The use of intensity modulated radiation allows some sparing of salivary glands but still results in xerostomia in > 40% of patients. Patients with radiation-induced xerostomia can develop dental caries, impaired swallowing ability, difficulty speaking, and diminished taste. These associated symptoms can have a major negative impact on the overall quality of life. Current treatment options for radiation-induced xerostomia are generally supportive in nature. Patients are encouraged to increase water consumption, consume specially prepared food, utilize salivary substitutes or attempt to stimulate salivary production through the use of parasympathomimetic drugs, organic acids, chewing gum, or sugar-free mints.
Most of these supportive interventions do not reverse xerostomia and are palliative in intent.
Marrow-derived mesenchymal stem cells (MSCs) are a viable cell based therapy for xerostomia. MSCs are a cellular product that can be derived from bone marrow and propagated ex vivo using established methods. This pilot study will provide strong evidence that marrow (MSCs) can be expanded to the extent necessary to support auto-transplantation in patients previously treated with radiation or chemoradiation for head and neck cancer. Ultrasound (US) will be used to measure the salivary gland size of subjects. This measurement will then allow researchers to estimate the maximum volume of MSCs that could be injected into a patient for treatment of xerostomia.