Radiation-induced hyposalivation and its treatment with oral pilocarpine

Niedermeier, W; Matthaeus, C; Meyer, Carolin; Staar, Susanne; Müller, Roman‐Ulrich; Schulze, Hans‐Joachim

doi:10.1016/s1079-2104(98)90343-2

Cited by 48 publications

(41 citation statements)

References 25 publications

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“…Xerostomia is commonly reported by patients after the first week of RT, and an increase in its severity is observed along the weeks of RT [8]. The sensation of dry mouth may extend for long periods after the end of RT [9]. …”

Section: Introductionmentioning

confidence: 99%

Oral shedding of human herpesviruses in patients undergoing radiotherapy/chemotherapy for head and neck squamous cell carcinoma is not affected by xerostomia

Palmieri

Ornaghi

Martins

et al. 2018

Journal of Oral Microbiology

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Background: Xerostomia is a very relevant and frequent complication of radiotherapy, causing the irradiated oral mucosa to be affected by bacterial, fungal and viral infections. Objective: The objective of this study was to evaluate a possible relationship between oral shedding of human herpesviruses and xerostomia in patients with squamous cell carcinoma of head and neck submitted to radio/chemotherapy. Methods: In this study, oral rinse samples were collected weekly from 20 patients during radiotherapy. The samples were submitted to PCR and enzymatic digestion for detection of human herpesviruses. Xerostomia was evaluated according to the Seminars in Radiation Oncology criteria. Results: There was a higher frequency of grade 1 xerostomia (51.4%), observed first in the 1st week of radiotherapy. In the 4th week of radiotherapy, all patients presented some degree of xerostomia. Analysis of herpesviruses showed oral shedding of EBV, HHV-6 and HHV-7 in all weeks. Considering all the periods, the highest frequency was in patients with EBV excretion (55.0%), which was significantly higher than that of other viruses. Conclusion: We observed that oral shedding of herpesviruses was not affected by xerostomia as there was a progression in their excretion, even with the evolution of xerostomia. This suggested that there is a local replication in the oral cavity that is not completely dependent of salivary excretion.

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Section: Introductionmentioning

confidence: 99%

Oral shedding of human herpesviruses in patients undergoing radiotherapy/chemotherapy for head and neck squamous cell carcinoma is not affected by xerostomia

Palmieri

Ornaghi

Martins

et al. 2018

Journal of Oral Microbiology

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“…The sparing of the contralateral major salivary glands has, therefore, a beneficial effect on oral health as measured by saliva flow, pH, buffer capacity, and colonisation with Streptococcus mutans. The most important contribution to preservation of salivary gland function is a treatment application technique which spares as much gland tissue as possible [6], since the pharmocologic treatment, either as a radioprotection [2,9,21,22,24] or a stimulation of the secretion rate [12,15,18,20] seems to work in only half of all patients. In this context, the function of the small salivary glands in the cavum oris has to be pointed out, even if their importance for oral health is still underestimated.…”

Section: Discussionmentioning

confidence: 99%

Sparing of Contralateral Major Salivary Glands Has a Significant Effect on Oral Health in Patients Treated with Radical Radiotherapy of Head and Neck Tumors

Beer

Zehnder

Lussi

et al. 2002

Strahlentherapie und Onkologie

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“…The results showed that pilocarpine is superior to placebo to relieve xerostomia complaints. At the present time it has been well established that oral pilocarpine is able to improve sicca symptoms, in particular those related to eyes and mouth in patients with systemic disorders such as Sjögrens syndrome (22)(23)(24) or other autoimmune conditions (25) and secondary to radiation therapy (26). After oral administration, the most common side effect is sweating, but urinary and gastrointestinal disturbances are also frequently reported (3,6,22).…”

Section: Introductionmentioning

confidence: 99%

Effect of pilocarpine mouthwash on salivary flow

Bernardi

Perin

Becker

et al. 2002

Braz J Med Biol Res

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Pilocarpine is a cholinergic agonist that increases salivary flow and has been used to treat xerostomia. Oral intake is the most frequent route of administration. Adverse effects are dose-dependent and include sudoresis, facial blushing and increased urinary frequency. The objective of the present study was to evaluate the effects of topical pilocarpine solutions as mouthwashes on salivary flow and their adverse effects on healthy subjects. Forty volunteers received 10 ml 0.5, 1 and 2% pilocarpine solutions or 0.9% saline in a randomized, double-blind, placebo-controlled manner. Salivation was measured before and 45, 60 and 75 min after mouth rinsing for 1 min with 10 ml of saline or pilocarpine solutions. Vital signs were measured and ocular, gastrointestinal and cardiovascular symptoms, anxiety and flushing were estimated using visual analog scales. There was a dosedependent increase in salivation. Salivation measured after 1 and 2% pilocarpine (1.4 ± 0.36 and 2.22 ± 0.42 g, respectively) was significantly (P<0.001) higher than before (0.70 ± 0.15 and 0.64 ± 0.1 g), with a plateau between 45 and 75 min. Cardiovascular, visual, gastrointestinal and behavioral symptoms and signs were not changed by topical pilocarpine. Mouth rinsing with pilocarpine solutions at concentrations of 1 to 2% induced a significant objective and subjective dose-dependent increase in salivary flow, similar to the results reported by others studying the effect of oral 5 mg pilocarpine. The present study revealed the efficacy of pilocarpine mouthwash solutions in increasing salivary flow in healthy volunteers, with no adverse effects. Additional studies on patients with xerostomia are needed.

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Radiation-induced hyposalivation and its treatment with oral pilocarpine

Cited by 48 publications

References 25 publications

Oral shedding of human herpesviruses in patients undergoing radiotherapy/chemotherapy for head and neck squamous cell carcinoma is not affected by xerostomia

Oral shedding of human herpesviruses in patients undergoing radiotherapy/chemotherapy for head and neck squamous cell carcinoma is not affected by xerostomia

Sparing of Contralateral Major Salivary Glands Has a Significant Effect on Oral Health in Patients Treated with Radical Radiotherapy of Head and Neck Tumors

Effect of pilocarpine mouthwash on salivary flow

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