الفهرس 
INTRODUCTION and Aim of the work.Only 14 pages are availabe for public view
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Abstract
1- Quantitative salivary gland scintigraphy using 99mTc-pertechnetate is an easy method for assessment of salivary gland function, as the test is simple, non invasive and has no technical difficulties. Also, the test has an acceptable variability, which may contribute to optimize dose-response studies in radiotherapy in an attempt to reduce incidence and severity of salivary gland dysfunction. 2- Although, sailometery was more sensitive, in the present work, in detecting salivary glands impairment, than sialoscintigraphy, the sialometery is technically difficult and needs some skills in collecting the salivary glands secretion and in some cases of oral cancers it may be impossible. 3-Consequently, sialochemistry add to sialoscintigraphy more information about the stimulated salivary gland samples, as sodium and chloride concentrations were elevated in patients saliva irradiated to different dose levels. 4- Considering the sensitivity of sialoscintigraphy, it may be of use to the clinician since it enables to measure the response of irradiated glands to different sialogogues which may be used in the management of xerostomia. 5- Xerostomia is considered one of the important troublesome sequalae after radiotherapy treatment of head and neck cancer. Strategies to reduce acute and late morbidity associated with such treatment will be divided into three categories: a) Treatment techniques. b) Symptom management or supportive care. c) Toxicity antagonist. a) Treatment techniques: This fulfilled by multidisciplinary clinic for proper management of case, complete history taking complete clinical examination of patient before treatment to detect exten of disease, treatment planing for each patient and patient education. Moreover treatment simulation and treatment planing with portal image and beam direction with selection of proper energy and proper fraction size is also mandatory to minimise any sequalae. b) Symptom management and supportive care: This can be achieved by the use of analgesic, antibiotic and antifungal during radiotherapy treatment also use of sucralfate was found useful to reduce mucositis. c) Toxicity antagonist was found outmost importance to reduce radiation complication after treatment of cancer in the head and neck region since they protect the mucosa, salivary flow and neurological tissue from the deleterious effect of radiation for example use of Amifostine, Pilocarpine and Prostaglandine analogue.