Topical pilocarpine for xerostomia in patients with head and neck cancer treated with radiotherapy

Topical pilocarpine for xerostomia in patients with head and neck cancer treated with radiotherapy:

Abstract

Objective

To evaluate a pilocarpine spray as a treatment for xerostomia in patients treated with radiotherapy (RT) for head and neck cancer (HNC).

Methods

This was a placebo‐controlled, double‐blind, crossover clinical trial of patients complaining of dry mouth after RT for HNC. Forty patients were randomly assigned to either placebo or pilocarpine (1.54%) spray and instructed to use 3 times a day for three months. After one‐month washout period, patients were crossed over to receive placebo or pilocarpine. The assessments were salivary flow (Stimulated Whole Saliva Flow‐SWSF), xerostomia (Xerostomia Inventory ‐ XI) and quality of life (QoL/Oral Health Impact Profile ‐ OHIP‐14), assessed at baseline, one hour (only SWSF), and at one, two and three months of treatment.

Results

Posttreatment SWFS was not statistically different between pilocarpine and placebo regardless of the treatment sequence (paired T test; p>0.05), except for the SWFS rates at two months after therapy. When comparing pilocarpine with placebo in the time points, there was no significant difference (p>0.05) for QoL or XI. Significant differences of improvement in QoL and xerostomia experience appeared along time for pilocarpine group.

Conclusion

The topical application of pilocarpine spray tested was similar to placebo on SWSF assessments in patients treated with RT for HNC.