What do systematic reviews say?

Amifostine vs no treatment/placebo

Amifostine may leads to higher allergic response (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 7.51 [1.40, 40.39]
  3 studies · 524 participants
  Low

Polaprezinc vs Azulene oral rinse

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

• 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

• 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

• 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

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

• 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

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 quality of life data were reported.
  0 studies
  No studies found

Selenium vs no intervention

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 survival data were reported.
  0 studies
  No studies found

Polaprezinc vs Azulene oral rinse

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

• 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

Chinese medicine led to lower xerostomia (dichotomous, Shenqi Fanghou recipe) 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 0.39 [0.28, 0.55]
  1 study · 140 participants
  GRADE not reported

Amifostine (intravenous) vs Amifostine (subcutaneous)

• 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

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 either quality of life or other oral related symptoms were reported.
  0 studies
  No studies found

Amifostine vs no treatment/placebo

Amifostine may leads to higher vomiting (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 4.90 [2.87, 8.38]
  5 studies · 601 participants
  Low

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
  Insufficient evidence of differences for loss of taste or dysphagia; data largely unusable (no standard deviations). Ageusia milder in selenium group (not significant); dysphagia significant only at week 7 (P = 0.05)…
  1 study
  GRADE not reported

Amifostine (intravenous) vs Amifostine (subcutaneous)

Amifostine (intravenous) showed no clear difference in overall survival 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 1.36 [0.89, 2.10]
  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 allergic response (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 1.00 [0.15, 6.64]
  1 study · 60 participants
  GRADE not reported

Amifostine vs no treatment/placebo

Amifostine showed no clear difference in asthenia (adverse effect) compared with no treatment/placebo; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  RR 2.91 [0.31, 27.24]
  1 study · 130 participants
  GRADE not reported

Chinese medicine vs no treatment/placebo

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

  End of RT; 1 month after RT
  No evidence of a difference for Tianwang Buxin Mini-pills (Lin 2014, 71 participants) or Jinlong capsules (Han 2010, 95 participants)
  2 studies
  GRADE not reported

Pilocarpine vs no treatment/placebo

It is very uncertain whether pilocarpine changes overall survival 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
  RR 1.07 [0.80, 1.43]
  1 study · 60 participants
  Very low

Polaprezinc vs Azulene oral rinse

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

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

  Over RT period
  RR 0.36 [0.17, 0.77]
  1 study · 31 participants
  GRADE not reported

Chinese medicine vs no treatment/placebo

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

  End of intervention to 3 months postRT
  Insufficient evidence to determine any effect on quality of life (Lin 2014; Analysis 6.5)
  1 study
  GRADE not reported