What do systematic reviews say?

Amifostine vs no treatment/placebo

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

  End of RT to 12 months postRT
  Insufficient evidence of a difference in stimulated salivary flow at any time point: end of RT MD -0.09 (95% CI -1.48 to 1.30); 3 months MD 0.38 (95% CI -1.43 to 2.19); 12 months MD 0.82 (95% CI -0.47 to 2.11);…
  2 studies
  GRADE not reported

Antimicrobial lozenge vs placebo

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

  Over 6 months
  Insufficient evidence of a difference: dryness in mouth RR 1.18 (95% CI 0.97 to 1.42), diarrhoea RR 1.97 (95% CI 0.51 to 7.54), constipation RR 0.91 (95% CI 0.59 to 1.42) (Duncan 2005)
  1 study
  GRADE not reported

Antiseptic mouthrinse 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
  No data on xerostomia were reported.
  0 studies
  No studies found

Pilocarpine vs no treatment/placebo

Pilocarpine led to higher speech difficulties (VAS 0-100 mm) 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 20.20 [1.93, 38.47]
  1 study · 34 participants
  GRADE not reported

G‐CSF vs placebo or no treatment

Granulocyte-colony stimulating factor (G-CSF) showed no clear difference in normalcy of diet (percutaneous endoscopic gastrostomy) compared with placebo or no treatment; GRADE not reported.

• 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 0.16 [0.01, 2.86]
  1 study · 40 participants
  GRADE not reported

Amifostine vs no treatment/placebo

Amifostine led to higher salivary flow rate (incidence of > 0.1 g saliva/5 min, unstimulated) 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 months postRT
  RR 1.45 [1.13, 1.86]
  1 study · 175 participants
  GRADE not reported

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

Keratinocyte growth factor (KGF; palifermin or repifermin),… showed no clear difference in normalcy of diet (total parenteral nutrition) 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

  BMT/SCT after conditioning for haematological cancers
  RR 0.89 [0.58, 1.34]
  4 studies · 714 participants
  GRADE not reported

Acupuncture vs sham control

• Interventions for managing taste disturbances 2017 · Cochrane All outcomes
  Results (health-related quality of life): Brandt 2008 assessed HRQoL in dysgeusia patients and reported significant improvement in psychological symptoms in the acupuncture group and increased quality of life in both…
  1 study
  GRADE not reported

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

Amifostine 200 mg/m2 three times weekly showed no clear difference in vomiting (adverse effect) compared with amifostine 200 mg/m2 five times weekly; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  RR 0.25 [0.06, 1.08]
  1 study · 60 participants
  GRADE not reported

Pilocarpine vs no treatment/placebo

Pilocarpine may leads to higher sweating (adverse effect) compared with no treatment/placebo (low certainty).

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  RR 2.98 [1.43, 6.22]
  5 studies · 389 participants
  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

  End of RT and 6, 12, 18, 24 months postRT
  No significant differences between the three treatment arms (Jellema 2006)
  1 study
  GRADE not reported

GM-CSF vs placebo or no treatment

Granulocyte-macrophage colony-stimulating factor (GM-CSF) showed no clear difference in normalcy of diet (tube feeding) compared with placebo or no treatment; GRADE not reported.

• 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 0.31 [0.01, 7.09]
  1 study · 29 participants
  GRADE not reported

Erythropoietin mouthwash vs placebo

Erythropoietin mouthwash showed no clear difference in number of days in hospital 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
  MD -2.95 [-7.73, 1.83]
  1 study · 80 participants
  GRADE not reported

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

Keratinocyte growth factor (KGF; palifermin or repifermin),… showed no clear difference in number of days of treatment with opioid analgesics 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

  BMT/SCT after conditioning for haematological cancers
  MD -1.41 [-3.33, 0.51]
  2 studies · 323 participants
  GRADE not reported

Zinc vs placebo

It is very uncertain whether zinc supplements (zinc sulphate, zinc gluconate, zinc picolinate,… changes adverse events compared with placebo (very low certainty).

• Interventions for managing taste disturbances 2017 · Cochrane All outcomes

  12 to 18 weeks
  RR 5.20 [0.90, 30.19]
  3 studies · 335 participants
  Very low

Venalot Depot (coumarin plus troxerutin) vs placebo

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  Sialometric data dropped to an unmeasurable level in both groups; abandoned as a marker of efficacy (Grotz 2001)
  1 study
  GRADE not reported

Amifostine vs no treatment/placebo

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

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  RR 9.20 [2.84, 29.83]
  3 studies · 376 participants
  Low

Zinc vs placebo

It is very uncertain whether zinc supplements (zinc sulphate, zinc gluconate, zinc picolinate,… changes taste acuity improvement - objective outcome (dichotomous data) compared with placebo (very low certainty).

• Interventions for managing taste disturbances 2017 · Cochrane All outcomes

  Mean 3 months · Idiopathic/zinc-deficient taste disorder
  RR 1.42 [1.09, 1.84]
  2 studies · 292 participants
  Very low

Biperiden plus pilocarpine vs no treatment

Biperiden plus pilocarpine showed no clear difference in dysphagia (WHO grade 3+) compared with no treatment; GRADE not reported.

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

  12 months postRT
  RR 0.25 [0.03, 2.11]
  1 study · 60 participants
  GRADE not reported

Acupuncture vs sham control

The review found no eligible studies for this question.

• Interventions for managing taste disturbances 2017 · Cochrane All outcomes
  Results: The acupuncture trial (Brandt 2008) did not give any data on adverse events in either group.
  0 studies
  No studies found