HISTOLOGICAL CHANGES IN SALIVARY GLANDS SUBJECTED TO RADIOTHERAPY IN HEAD AND NECK CANCER

Abstract

Radiotherapy is fundamental in the treatment of head and neck cancer, but often causes damage to salivary glands, resulting in xerostomy and compromising quality of life. Strategies to minimize these effects include radioprotective agents, cell therapies and technologies such as radiotherapy FLASH. The aim of this review was to analyze updated information on histological and functional alterations of salivary glands submitted to radiotherapy, in addition to identifying strategies for tissue protection and regeneration. Articles published between 2020 and 2025 in the SciELO, PubMed and LILACS/MEDLINE databases were selected, using descriptors related to salivary glands, radiotherapy and head and neck cancer. The results indicate acinar degeneration, fibrosis, chronic inflammation and reduced salivary secretion, with significant clinical impacts. There was variability between different glands and radiotherapy protocols, as well as persistence of long-term changes. Glandular damage involves complex mechanisms, including vascular injury, inflammation and programmed cell death. Preventive interventions and regenerative therapies may preserve salivary function, but face challenges related to individual heterogeneity and molecular complexity. It is concluded that, although radiotherapy is essential in cancer treatment, its adverse effects on salivary glands require integrated and multidisciplinary strategies.