Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy

Abstract

There is some low-quality evidence to suggest that amifostine prevents the feeling of dry mouth in people receiving radiotherapy to the head and neck (with or without chemotherapy) in the short- (end of radiotherapy) to medium-term (three months postradiotherapy). However, it is less clear whether or not this effect is sustained to 12 months postradiotherapy. The benefits of amifostine should be weighed against its high cost and side effects. There was insufficient evidence to show that any other intervention is beneficial.

Hyperbaric oxygen treatment for the management of radiation‐induced xerostomia

“…As medical oxygen is a pharmacological agent when used in the hyperbaric environment, it is hoped that future reviews will rectify this omission to allow meta-analysis inclusion. 5 In conclusion, HBOT may be a safe and effective treatment for LSTRI of the salivary gland and symptoms of xerostomia. It should be considered when available and may prevent the need for dental extractions in the long term for high-risk patients.…”

“…A recent Cochrane systematic review on pharmacological interventions for preventing xerostomia did not include HBOT in the search criteria. As medical oxygen is a pharmacological agent when used in the hyperbaric environment, it is hoped that future reviews will rectify this omission to allow meta‐analysis inclusion …”

“…Pharmacological therapies are poorly tolerated by patients, and there is little supporting evidence for complementary therapies such as acupuncture or herbal treatments . Amifostine has low‐quality evidence of effectiveness for early radiation‐induced xerostomia, but not late soft tissue radiation injury (LSTRI) . Hence, there is high interest in an effective treatment strategy for these patients.…”

“…4 Amifostine has low-quality evidence of effectiveness for early radiation-induced xerostomia, but not late soft tissue radiation injury (LSTRI). 5 Hence, there is high interest in an effective treatment strategy for these patients.…”

Avaliação de toxicidades tardias em pacientes com carcinoma epidermoide de cabeça e pescoço submetidos a quimiorradiação concomitante baseada em cisplatina

“…Não há evidência suficiente para se recomendar qualquer outra medida farmacológica como prevenção ao desenvolvimento de xerostomia nos pacientes submetidos a QRT concomitante (131) .…”