title: Systematic literature review: xerostomia in advanced cancer patients.
abstract: OBJECTIVE
  Dry mouth (xerostomia) is one of the commonest symptoms in cancer patients and can adversely affect quality of life. The aim of this review was to determine the effectiveness of pharmacological and non-pharmacological interventions in treating xerostomia in adult advanced cancer patients.
  
  
  METHODS
  The literature search was performed in February 2014 using databases including EMBASE, MEDLINE, CINAHL, BNI and Cochrane library. The search was carried out using standard MeSH terms and was limited to adult population and English language. Studies investigating xerostomia secondary to head and neck cancer treatment and autoimmune disease were excluded. Titles and abstracts were screened and reviewed for eligibility. Only studies involving primary research were included in the analysis.
  
  
  RESULTS
  Six studies met the eligibility criteria for review: three randomized controlled trials and three prospective studies. The quality assessment and reporting was performed using PRISMA, Jadad and STROBE. These studies compared acupuncture, pilocarpine, Saliva Orthana and chewing gum with each other or with placebo. All interventions were considered effective in treating xerostomia. However, effectiveness versus placebo could not be demonstrated for Saliva Orthana. Meta-analysis could not be performed due to heterogeneity of the study type and intervention.
  
  
  CONCLUSIONS
  Limited published data exists reporting the effectiveness of measures in the treatment of xerostomia in cancer patients. Based on primary research of low quality, firm conclusions cannot be drawn. However, pilocarpine, artificial saliva, chewing gum and acupuncture can be tried based on the available data. This highlights the explicit need to improve our evidence base. Properly constructed randomized controlled trials demonstrating effectiveness of pharmacological and non-pharmacological interventions for dry mouth are required.
authors.affiliation: Yorkshire Deanery, Leeds, West Yorshire, UK, shanchanale@gmail.com.
authors.forename: Sarika
authors.initials: S
authors.lastname: Hanchanale
authors.forename: Lucy
authors.initials: L
authors.lastname: Adkinson
authors.forename: Sunitha
authors.initials: S
authors.lastname: Daniel
authors.forename: Michelle
authors.initials: M
authors.lastname: Fleming
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Oxberry
mesh_terms: D015670:Acupuncture Therapy; D000328:Adult; D002638:Chewing Gum; D018450:Disease Progression; D006801:Humans; D009369:Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy*; D010862:Pilocarpine / Q000627:therapeutic use; D011446:Prospective Studies; D011788:Quality of Life; D012464:Saliva, Artificial; D014987:Xerostomia / Q000209:etiology* / Q000628:therapy*
chemical_list: D002638:Chewing Gum; D012464:Saliva, Artificial; D010862:Pilocarpine