Findings

What do systematic reviews say?

571 questions · 628 findings · 20 reviews · Oral medicine and oral cancer

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No studies found 73 · 11.6%GRADE not reported 459 · 73.1%Very low 49 · 7.8%Low 30 · 4.8%Moderate 17 · 2.7%High 0 · 0%

Amifostine 200 mg/m2 three times weekly vs Amifostine 200 mg/m2 five times weekly

Survival (overall survival and locoregional control) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Insufficient evidence reported on overall survival or locoregional tumour control (Analysis 4.2; 4.3)
1 study
GRADE not reported

Biperiden plus pilocarpine vs no treatment

Side effects · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No data were reported on side effects.
0 studies
No studies found

Amifostine (intravenous) vs Amifostine (subcutaneous)

Locoregional control · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Amifostine (intravenous) showed no clear difference in locoregional tumour control compared with amifostine (subcutaneous); GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
48 months postRT
HR 1.34 [0.76, 2.36]
1 study
GRADE not reported

Bethanechol vs placebo

Survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No survival data were reported.
0 studies
No studies found

Amifostine vs no treatment/placebo

Cost (mean per-patient supportive care costs) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
Mean per-patient supportive care costs lower with amifostine (USD 4401) than control (USD 5873); P = 0.02 (Buntzel 1998 / Bennett 2001)
1 study · 28 participants
GRADE not reported

Pilocarpine vs no treatment/placebo

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Pilocarpine led to lower xerostomia (objective, LENT-SOMA scale) compared with no treatment/placebo; GRADE not reported.

3 findings from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
6 months postRT
MD -0.40 [-0.69, -0.11]
1 study · 39 participants
GRADE not reported
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT; 3 months postRT
RR 1.00 [0.92, 1.08]
2 studies · 48 participants
GRADE not reported
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 6 months postRT
SMD -0.35 [-1.04, 0.33]
2 studies · 126 participants
Very low

Amifostine (intravenous) vs Amifostine (subcutaneous)

Salivary flow rate · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No salivary flow rate data related to routes of administration of amifostine were reported.
0 studies
No studies found

Amifostine vs no treatment/placebo

Adverse effects (other reported events) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Alopecia, skin toxicity, hot flush, drowsiness, sneezing, hiccupping, dizziness and fatigue reported narratively or only for the amifostine group; insufficient evidence of a difference
Studies not reported
GRADE not reported

Amifostine vs no treatment/placebo

Xerostomia (grade >= 2, 0-4 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Amifostine may leads to lower xerostomia (grade >= 2, 0-4 scale) compared with no treatment/placebo (low certainty).

3 findings from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
RR 0.35 [0.19, 0.67]
3 studies · 119 participants
Low
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
12 months postRT
RR 0.70 [0.40, 1.23]
7 studies · 682 participants
Low
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 3 months postRT
RR 0.66 [0.48, 0.92]
5 studies · 687 participants
Low

Amifostine vs no treatment/placebo

Allergic adverse events · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Amifostine may leads to higher allergic response (adverse effect) compared with no treatment/placebo (low certainty).

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
RR 7.51 [1.40, 40.39]
3 studies · 524 participants
Low

Polaprezinc vs Azulene oral rinse

Taste disturbance (severe, > 2 on 0-3 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Polaprezinc led to lower taste disturbance (severe, > 2 on 0-3 scale) compared with azulene oral rinse; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Over RT period
RR 0.12 [0.02, 0.83]
1 study · 31 participants
GRADE not reported

Keratinocyte growth factor (KGF; palifermin or repifermin), intravenous vs placebo

Adverse effects · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No evidence of a difference in reported adverse events across the three trials (nausea, fever, constipation, diarrhoea, headache, fatigue and others)
3 studies
GRADE not reported

Chinese medicine vs no treatment/placebo

Xerostomia (VAS) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
Difference in favour of Chinese medicine on VAS xerostomia (P < 0.05); standard deviations not available (Wang 1998)
1 study · 50 participants
GRADE not reported

Antimicrobial lozenge vs placebo

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Antimicrobial lozenge showed no clear difference in xerostomia compared with placebo; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 3 months postRT
RR 1.16 [0.97, 1.40]
1 study · 133 participants
GRADE not reported

Antiseptic mouthrinse vs placebo

Quality of life · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No quality of life data were reported.
0 studies
No studies found

Selenium vs no intervention

Survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No survival data were reported.
0 studies
No studies found

Polaprezinc vs Azulene oral rinse

Xerostomia (severe) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Polaprezinc led to lower xerostomia (severe) compared with azulene oral rinse; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
RR 0.17 [0.04, 0.65]
1 study · 31 participants
GRADE not reported

Chinese medicine vs no treatment/placebo

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Chinese medicine led to lower xerostomia (dichotomous, Shenqi Fanghou recipe) compared with no treatment/placebo; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
RR 0.39 [0.28, 0.55]
1 study · 140 participants
GRADE not reported

Amifostine (intravenous) vs Amifostine (subcutaneous)

Adverse effects · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Increased hypotension with intravenous delivery (20% vs 8%; P = 0.007); skin rash (10% vs 22%; P = 0.012) and local pain at injection site (0% vs 8%; P = 0.001) worse with subcutaneous; inconclusive for…
1 study
GRADE not reported

Bethanechol vs placebo

Quality of life · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No data on either quality of life or other oral related symptoms were reported.
0 studies
No studies found