Efficacy of pilocarpine lozenge for post-radiation xerostomia in patients with head and neck cancer.
BACKGROUND
Patients with radiation-induced xerostomia produce little or no saliva. Several studies have demonstrated the efficacy of systemic administration of pilocarpine hydrochloride in individuals with post-radiation xerostomia. However, analysis of pilocarpine lozenges for treatment of post-radiation xerostomia in patients with head and neck cancer has not been reported.


METHODS
The aim of this study was to quantify improvement in clinical symptoms and salivary function after treatment of post-radiation xerostomia with pilocarpine lozenges. In a double-blinded, placebo-controlled trial, 33 head and neck cancer patients were assigned randomly to receive Salagen tablet, pilocarpine hydrochloride lozenge (3 or 5 mg) or placebo lozenge every 10 days. At each visit, a subjective evaluation was undertaken through the use of visual analog scales before and at 180 minutes after treatment. Whole resting saliva was collected before and at 0, 30, 60, 90, 120, 150 and 180 minutes after treatment.


RESULTS
The percentage of patients with decreased feeling of oral dryness, sore mouth or speaking difficulties after taking 5-mg pilocarpine lozenge was greater than Salagen or placebo. There were statistically significant increases in salivary production in pilocarpine treatment groups vs. placebo (P < 0.05).


CONCLUSIONS
The 5-mg pilocarpine lozenge produced the best clinical results, but further investigation with a larger group of patients is required.
Taweechaisupapong
S
S
Department of Oral Diagnosis, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand. suvi_taw@kku.ac.th
Pesee
M
M
Aromdee
C
C
Laopaiboon
M
M
Khunkitti
W
W
D000328:Adult; D016371:Cranial Irradiation / Q000009:adverse effects*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D018721:Muscarinic Agonists / Q000008:administration & dosage*; D017060:Patient Satisfaction; D010862:Pilocarpine / Q000008:administration & dosage*; D012472:Salivation / Q000187:drug effects; D011795:Surveys and Questionnaires; D013607:Tablets; D016896:Treatment Outcome; D014987:Xerostomia / Q000188:drug therapy* / Q000209:etiology
D018721:Muscarinic Agonists; D013607:Tablets; D010862:Pilocarpine