Fernández LRG, Cortés ANZ, Ochoa CFJ, Poitevin CMA, Pérez THE

Language: Spanish
References: 10
Page: 149-153
PDF size: 163.19 Kb.

ABSTRACT

The objective of this study was to evaluate the response of pilocarpine in patients with xerostomy induced by radiotherapy in head and neck. Twenty patients of the Instituto Nacional de Cancerología (INCan) participated. A randomized, prospective and longitudinal study was carried out. The control group (n = 10) received a placebo. The study group (n = 10) was medicated daily with 5 mg of pilocarpine every 8 hours. Salivary flux was quantified three times: at the beginning of the treatment, at the fourth and at the seventh week. The quantification was realized by the mass difference method. When the first quantification was carried out at the beginning of radiotherapy treatment, no patient had received medication. Comparing both groups we obtained t = 0.525, p = 0.606, so that there was no statistically significant difference in salivary flux. In the fifth week a reduction of salivary flux in both groups was observed, when the groups were compared there was no statistically significant difference between them (t = 0.481, p = 0.636). In the seventh week a significative increment in salivary flux in the study group compared with the control group was observed. For the study group the values were: mean = 0.651 and standard deviation = 0.380, while for the control group the values were: mean = 0.256 and standard deviation = 0.251. By comparing the groups with t-Student test, the results were: t = 2.743, p = 0.013. It is concluded that pilocarpine is an alternative, viable, safe and economic treatment for xerostomy induced by radiotherapy.

REFERENCES

1. Davies AN, Singer JM. A comparison of artificial saliva and pilocarpine in radiation induced xerostomia. J of Laringology and Otology 1994; 108: 663-65.

2. Rhodus L, Schuh MJ. Effects of pilocarpine on salivary floor in patients with Sjögre’n syndrome. Oral Surgery Oral Medicine Oral Patholoy 1991; 72: 545-9.

3. Davis AN. A comparison of artificial saliva and chewing gum in the management of xerostomia in patients with advanced cancer. Palliative Medicine 2000; 14: 197-203.

4. Seikaly H, Jha N, McGaw T et al. Submandibular gland transfer: a new method of preventing radiation-induced xerostomia. Laryngoscope 2001; 111(2): 347-52.Â

5. Johnstone PA, Peng YPP, May BC, Inouye WS, Nietmtzow RC. Acupuncture for pilocarpine-resistant xerostomia following radiotherapy for head and neck malignancies. Int J Radiat Oncol Biol Phys 2001; 50: 53-357.

6. Ingrid VH, Wolf, Alkinson, Jane C, Macnsk A, Fox P. Use of pilocarpine during head and neck radiation therapy to reduce xerostomia and salivary dysfunction. Cancer 1993; 71: 663-65.

7. Fisher J, Scott C, Scarantino CW et al. Phase III quality-of-life study results: Impact on patients’ quality of life to reducing xerostomia after radiotherapy for head-and-neck cancer—RTOG 97-09. Int J Radiat Oncol Biol Phys 2003; 56(3): 832-6.

8. Jonson JT, Ferretti GA, Nethery WJ, Ingrid HV, Fox PhC, David NG, Muscoplant CC, Gallagher SC. Oral pilocarpine for post-irradiation xerostomia in patients with head and neck cancer. The New England Journal of Medicine 1993; 329: 390-395.

9. Wiseman L, Faulds D. Oral pilocarpine. A review of its pharmacological properties and clinical potential in xerostomia. Adis International Limited 1992; 49: 143-155.

10. Shigaki SK, Tsutomo N, Tamio N. The role of radiotherapy in the management of salivary glands carcinomas. J of Cranio-Maxillo-Facial Surgery 1992; 20: 220-24.