Study on the mechanism of radioactive salivary gland injury: a relatively comprehensive statement

Radiation-induced salivary gland dysfunction (RSGD) is a common complication of radiotherapy in patients with head and neck cancers that leads to xerostomia and related oral complications. It reduces treatment tolerance and quality of life, while current clinical interventions only alleviate superficial symptoms and fail to restore salivary gland function. This highlights the necessity to explore the pathogenesis of RSGD and to identify targets; existing studies have focused on DNA damage, oxidative stress, and fibrosis, but lack insights into emerging mechanisms such as ferroptosis, and therapies require improvement.

Based on models of radiation-induced salivary gland injury, this review had two core tasks: 1) to systematically explore multi-dimensional injury mechanisms, including existing and latest findings, and 2) to summarize current RSGD-related clinical drug regimens and stem cell/exosome-mediated therapies. The aims were to clarify core molecular mechanisms and potential targets, provide theoretical/practical references for novel effective therapies, overcome limitations in symptomatic treatment, and provide insights into how to improve outcomes and quality of life for patients with RSGD.