What do systematic reviews say?

Intervention diet vs usual on‐treatment diet

Summary of findings: Diet interventions showed no clear difference in diarrhoea (grade 1+) compared with usual on‐treatment diet (low certainty).

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  RR 0.74 [0.45, 1.23]
  1 study · 119 participants
  Low

Intervention diet vs usual on‐treatment diet

The review found no eligible studies for this question.

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Intervention diet vs usual on‐treatment diet

The review found no eligible studies for this question.

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Intervention diet vs usual on‐treatment diet

The review found no eligible studies for this question.

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Intervention diet vs usual on‐treatment diet

Summary of findings: Diet interventions showed no clear difference in mean GI symptom scores (Vaizey scale) (higher scores better) compared with usual on‐treatment diet (low certainty).

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 70 participants
  Low

Intervention diet vs usual on‐treatment diet

The review found no eligible studies for this question.

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Intervention diet vs usual on‐treatment diet

The review found no eligible studies for this question.

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Bethanechol vs Artificial saliva

Bethanechol showed no clear difference in xerostomia (dry mouth, yes/no) compared with artificial saliva; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  8 to 40 weeks postRT
  RR 0.56 [0.30, 1.05]
  1 study · 30 participants
  GRADE not reported
• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  End of RT
  RR 0.63 [0.30, 1.29]
  1 study · 36 participants
  GRADE not reported

Polaprezinc vs Azulene oral rinse

The review found no eligible studies for this question.

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

Bethanechol vs Artificial saliva

Bethanechol led to higher salivary flow rate (unstimulated, ml/min) compared with artificial saliva; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  End of RT
  MD 0.12 [0.01, 0.23]
  1 study · 36 participants
  GRADE not reported
• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  8 to 40 weeks postRT
  MD 0.07 [-0.02, 0.16]
  1 study · 33 participants
  GRADE not reported

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

Palifermin showed no clear difference in progression-free survival compared with placebo; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  42 to 72 months from baseline
  HR 1.06 [0.80, 1.42]
  3 studies
  GRADE not reported

Bethanechol vs Artificial saliva

Bethanechol showed no clear difference in overall survival compared with artificial saliva; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  40 weeks postRT
  RR 1.59 [0.43, 5.84]
  1 study · 43 participants
  GRADE not reported

Amifostine vs no treatment/placebo

Amifostine showed no clear difference in dysphagia (grade >= 3, 0-4 scale) compared with no treatment/placebo; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  End of RT; up to 3 months postRT
  RR 0.50 [0.17, 1.48]
  2 studies · 73 participants
  GRADE not reported

Polaprezinc vs Azulene oral rinse

The review found no eligible studies for this question.

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

Polaprezinc vs Azulene oral rinse

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  Tumour response by RECIST criteria reported for a specific group of patients only; no usable survival data (Watanabe 2010)
  1 study
  GRADE not reported

Chinese medicine vs no treatment/placebo

Chinese medicine led to higher salivary flow rate (stimulated) compared with no treatment/placebo; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  End of RT
  MD 0.09 [0.03, 0.15]
  1 study · 50 participants
  GRADE not reported

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

Palifermin showed no clear difference in xerostomia (grade >= 2, 0-4 scale) compared with placebo (low certainty).

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  Up to and including 3 months postRT
  RR 0.97 [0.77, 1.22]
  3 studies · 471 participants
  Low

Antiseptic mouthrinse vs placebo

Antiseptic mouthrinse showed no clear difference in drooling (hyposialosis) compared with placebo; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  4 weeks from baseline
  RR 1.43 [0.46, 4.39]
  1 study · 24 participants
  GRADE not reported

Pilocarpine vs no treatment/placebo

It is very uncertain whether pilocarpine changes quality of life (McMaster HNRQ, 1-7 scale) compared with no treatment/placebo (very low certainty).

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  Up to and including 6 months postRT
  MD 0.20 [-0.19, 0.59]
  1 study · 90 participants
  Very low

Amifostine vs no treatment/placebo

Amifostine showed no clear difference in disease-free survival compared with no treatment/placebo; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  24 months postRT
  RR 0.94 [0.73, 1.21]
  1 study · 170 participants
  GRADE not reported