The preventive and therapeutic effect of acupuncture for radiation-induced xerostomia in patients with head and neck cancer: a systematic review.
BACKGROUND
Methods currently available to prevent and manage xerostomia which caused by radiotherapy in patients with head and neck caner have limited efficacy. Some studies suggest that acupuncture may be beneficial.


OBJECTIVE
The authors evaluated the preventive and therapeutic effect of acupuncture for radiation-induced xerostomia among patients with head and neck cancer.


METHODS
PUBMED, EMBASE, Cochrane Library, CBM, CAJD, Wan Fang database, and VIP Database for Chinese Technical Periodicals were electronically searched, in conjunction with further manual search for relevant articles. Studies that met the inclusion criteria were systematically evaluated.


RESULTS
Three randomized controlled trials (RCTs) investigating the therapeutic effect of acupuncture were included. One RCT on the preventive effect of acupuncture was found. Because of the considerable variation among included studies, meta-analysis was not possible. Two included RCTs used placebo controls, and both observed significant improvement in the salivary flow rates between acupuncture and control groups. However, no significant differences were found. Three included RCTs suggested that acupuncture for radiation-induced xerostomia can improve patients' subjective symptoms. The only study evaluating the preventive effect of acupuncture for radiation-induced xerostomia showed positive changes in salivary flow rates (both unstimulated and stimulated) and dry mouth -related symptoms. Acupuncture treatment was well tolerated by all patients and no severe adverse effects were seen.


CONCLUSIONS
Insufficient evidence is available to judge whether acupuncture is safe and whether it is effective in preventing or treating radiation-induced xerostomia. Significant research remains to be done before acupuncture can be recommended for routine use in radiation-induced xerostomia.
Fudan University Shanghai Cancer Center, Shanghai, China.
Liping
L
Zhuang
Zongguo
Z
Yang
Xiantao
X
Zeng
Xiaoyan
X
Zhua
Zhen
Z
Chen
Luming
L
Liu
Zhiqiang
Z
Meng
D015670:Acupuncture Therapy / Q000379:methods; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D014987:Xerostomia / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy*