What do systematic reviews say?

Amifostine vs no treatment/placebo

Amifostine showed no clear difference in quality of life 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
  MD 0.52 [-0.02, 1.06]
  1 study · 233 participants
  GRADE not reported

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

The review found no eligible studies for this question.

• Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
  No studies reported this outcome (planned secondary outcome not measured by any study in the review)
  0 studies
  No studies found

Amifostine vs no treatment/placebo

It is very uncertain whether amifostine changes salivary flow rate (mg/5 min, unstimulated) compared with no treatment/placebo (very low certainty).

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

  12 months postRT
  MD 0.32 [0.09, 0.55]
  1 study · 27 participants
  Very low
• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  End of RT
  MD 0.34 [0.07, 0.61]
  83 participants
  GRADE not reported

Amifostine vs no treatment/placebo

Amifostine showed no clear difference in progression-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

  12 to 24 months postRT
  HR 0.94 [0.70, 1.27]
  2 studies · 247 participants
  GRADE not reported

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

• Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
  Adverse events attributed to KGF were typically oral-related or skin-related; mostly mild to moderate with very few serious events; reporting poor and inconsistent, not appropriate to meta-analyse (SoF comments cell,…
  16 studies
  GRADE not reported

Biperiden plus pilocarpine vs no treatment

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
  Survival not reported.
  0 studies
  No studies found

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

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
  None of the trials evaluating palifermin provided data on salivary flow rates.
  0 studies
  No studies found

Epidermal growth factor (EGF), oral spray vs placebo

Epidermal growth factor (EGF), oral spray showed no clear difference in oral mucositis (moderate to severe) compared with placebo; GRADE not reported.

• Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes

  Chemoradiotherapy to the head and neck
  RR 1.06 [0.78, 1.43]
  1 study · 136 participants
  GRADE not reported
• Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes

  Radiotherapy to the head and neck
  RR 0.67 [0.45, 0.99]
  1 study · 103 participants
  GRADE not reported

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

Keratinocyte growth factor (KGF), intravenous led to lower oral mucositis (any severity) compared with chlorhexidine mouthwash; GRADE not reported.

• Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes

  Children
  RR 0.67 [0.54, 0.85]
  1 study · 90 participants
  GRADE not reported

Amifostine vs no treatment/placebo

Amifostine led to lower dysgeusia (grade >= 2, 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
  RR 0.24 [0.10, 0.61]
  1 study · 28 participants
  GRADE not reported

Zinc supplements vs Acupuncture

The review found no eligible studies for this question.

• Interventions for managing taste disturbances 2017 · Cochrane All outcomes
  Authors' conclusions: We were unable to draw any conclusions regarding the superiority of zinc supplements or acupuncture as none of the trials compared these interventions.
  0 studies
  No studies found

Selenium vs no intervention

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

  6 weeks after end of RT
  No evidence that selenium reduced xerostomia; data unusable (bar charts with no standard deviations) (Buntzel 2010)
  1 study
  GRADE not reported

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

Palifermin showed no clear difference in overall survival compared with placebo (moderate certainty).

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

  42 to 72 months from baseline
  HR 1.00 [0.72, 1.39]
  3 studies
  Moderate

G‐CSF vs placebo or no treatment

Granulocyte-colony stimulating factor (G-CSF) may leads to lower oral mucositis (severe) compared with placebo or no treatment (low certainty).

• Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes

  RT to head and neck
  RR 0.37 [0.15, 0.87]
  2 studies · 54 participants
  Low

Antiseptic mouthrinse vs placebo

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  Salivary flow rate was only reported during radiotherapy (i.e. not at any of the time points of interest); no usable data (Lanzos 2010)
  1 study
  GRADE not reported

Pilocarpine vs no treatment/placebo

It is very uncertain whether pilocarpine changes salivary flow rate (unstimulated) 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 3 months postRT
  MD -0.06 [-0.23, 0.11]
  1 study · 24 participants
  Very low

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

• 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

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

The review found no eligible studies for this question.

• Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
  No studies reported this outcome (planned secondary outcome not measured by any study in the review)
  0 studies
  No studies found

Biperiden plus pilocarpine vs no treatment

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 were reported on side effects.
  0 studies
  No studies found

Amifostine (intravenous) vs Amifostine (subcutaneous)

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

• 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