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

• Published in: Oral diseases Vol. 26; no. 6; pp. 1209 - 1218
• Main Authors: Pereira, Raony Môlim de Sousa, Bastos, Mônica Danielle Ribeiro, Ferreira, Maíra Peres, Freitas, Osvaldo, Macedo, Leandro Dorigan, Oliveira, Harley Francisco, Ricz, Hilton Marcos Alvez, Motta, Ana Carolina Fragoso, Macedo, Ana Paula, Tirapelli, Camila, Pedrazzi, Vinicius
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01.09.2020
• Subjects: clinical trial; Clinical trials; Head & neck cancer; head and neck cancer; Patients; Pilocarpine; Quality of life; Radiation therapy; radiotherapy; Saliva; Topical application; Xerostomia; clinical trial; pilocarpine; radiotherapy; xerostomia; head and neck cancer; quality of life
• ISSN: 1354-523X; 1601-0825
• DOI: 10.1111/odi.13343

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 three times a day for 3 months. After 1‐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, 1 hr (only SWSF), and at 1, 2, and 3 months of treatment. Results Posttreatment SWFS was not statistically different between pilocarpine and placebo regardless of the treatment sequence (paired T test; p > .05), except for the SWFS rates at 2 months after therapy. When comparing pilocarpine with placebo in the time points, there was no significant difference (p > .05) for QoL or XI. Significant differences in 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.