Saliva substitute mouthwash in nasopharyngeal cancer survivors with xerostomia: a randomized controlled trial

Abstract

Objectives Xerostomia is a prevalent sequelae among nasopharyngeal cancer (NPC) survivors; yet, effective treatment protocols have been elusive. This study was a prospective randomized clinical trial to compare the effects of saliva substitute mouthwash in nasopharyngeal cancer survivors with xerostomia, between two treatment arms, conducted in a tertiary center. Materials and methods This study measured the effects within 4 weeks in relation to summated xerostomia inventory (SXI) and unstimulated whole saliva (UWS). Patients randomized into the interventional arm were prescribed an immunologically active saliva substitute (IASS), while patients in the control arm were prescribed a non-immunologically active mouthwash as placebo. Results The study population consisted of 94 patients. There was a significant difference in SXI difference (p < 0.0001) and UWS difference (p < 0.0001) between control and interventional arms. No harmful side effects associated with the use of either mouthwash encountered throughout the study duration. Conclusion IASS mouthwash significantly reduces subjective xerostomia scores measured using SXI and improves objective measurement of salivary flow using UWS among nasopharyngeal cancer survivors with xerostomia. Clinical relevance IASS is significantly more effective in improving subjective and objective xerostomia measurements compared to non-immunologically active mouthwash. Additionally, this treatment is very safe, with superior side effect profiles. Trial registration ClinicalTrials.gov Identifier: NCT04491435

Management of Oral Hygiene in Head-Neck Cancer Patients Undergoing Oncological Surgery and Radiotherapy: A Systematic Review

“…Marimuthu et al [ 30 ] evaluated the efficacy of an immunologically active saliva substitute mouthwash based on the Shortened Xerostomia Inventory and Unstimulated Whole Saliva , verifying the validity of the presidium. The study by Sio et al [ 27 ] also reports the potential benefits of N-acetylcysteine rinses in radio-chemotherapy-treated patients.…”

Perioperative symptom burden and its influencing factors in patients with oral cancer: A longitudinal study

“…Previous studies have confirmed that saliva substitutes were one of the most effective methods to alleviate dry mouth in cancer patients who had undergone radiotherapy. 40,41 Further research is needed to determine whether the saliva substitute is effective in postoperative oral cancer. This study also showed that self-employed patients had a higher symptom burden than farmers.…”

Quality of Life as a Mediator between Cancer Stage and Long-Term Mortality in Nasopharyngeal Cancer Patients Treated with Intensity-Modulated Radiotherapy

“…The second strategy entails enhancing QoL through specific interventions. Recommended interventions include the provision of swallowing function training and oral health care training to reduce the severity of dysphagia [38,39], the substitution of saliva for mouthwash to reduce xerostomia [40], implementation of regular home nursing interventions to improve global health [41], implementation of nutrition support and head-and-neck rehabilitation exercise to ameliorate fatigue [42], implementation of psychological interventions (particularly cognitive behavioral therapy) to mitigate depression or anxiety [43], and implementation of transdisciplinary geriatric and palliative care interventions to enhance the QoL of older adults with cancer [44].…”