Findings

What do systematic reviews say?

517 questions · 551 findings · 17 reviews · All outcomes

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No studies found 65 · 11.8%GRADE not reported 419 · 76%Very low 29 · 5.3%Low 25 · 4.5%Moderate 13 · 2.4%High 0 · 0%

Chinese medicine vs no treatment/placebo

Side 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
End of intervention; 1 month after RT
Insufficient evidence of a difference for any side effects
2 studies
GRADE not reported

Amifostine vs no treatment/placebo

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

Amifostine showed no clear difference in quality of life 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; up to 3 months postRT
MD 0.52 [-0.02, 1.06]
1 study · 233 participants
GRADE not reported

Amifostine vs no treatment/placebo

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

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

2 findings from 1 review

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

Progression‐free survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Amifostine showed no clear difference in progression-free survival 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
12 to 24 months postRT
HR 0.94 [0.70, 1.27]
2 studies · 247 participants
GRADE not reported

Biperiden plus pilocarpine vs no treatment

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
Survival not reported.
0 studies
No studies found

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

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

Amifostine vs no treatment/placebo

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

Amifostine led to lower dysgeusia (grade >= 2, 0-4 scale) 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 0.24 [0.10, 0.61]
1 study · 28 participants
GRADE not reported

Selenium vs no intervention

Dry mouth (xerostomia) · 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
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

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

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

1 finding from 1 review

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

Antiseptic mouthrinse vs placebo

Salivary flow rate · 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
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

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

It is very uncertain whether pilocarpine changes salivary flow rate (unstimulated) compared with no treatment/placebo (very low certainty).

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
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

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