Findings

What do systematic reviews say?

571 questions · 628 findings · 20 reviews · Oral medicine and oral cancer

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No studies found 73 · 11.6%GRADE not reported 459 · 73.1%Very low 49 · 7.8%Low 30 · 4.8%Moderate 17 · 2.7%High 0 · 0%

Bethanechol vs Artificial saliva

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

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

1 finding from 1 review

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

Dysphagia (grade >= 3, 0-4 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Amifostine showed no clear difference in dysphagia (grade >= 3, 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; up to 3 months postRT
RR 0.50 [0.17, 1.48]
2 studies · 73 participants
GRADE not reported

Polaprezinc vs Azulene oral rinse

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 on adverse events were reported.
0 studies
No studies found

Polaprezinc vs Azulene oral rinse

Survival · 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
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

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

Chinese medicine led to higher salivary flow rate (stimulated) 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
MD 0.09 [0.03, 0.15]
1 study · 50 participants
GRADE not reported

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

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

Palifermin showed no clear difference in xerostomia (grade >= 2, 0-4 scale) compared with placebo (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
RR 0.97 [0.77, 1.22]
3 studies · 471 participants
Low

Antiseptic mouthrinse vs placebo

Drooling (hyposialosis) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Antiseptic mouthrinse showed no clear difference in drooling (hyposialosis) compared with 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
4 weeks from baseline
RR 1.43 [0.46, 4.39]
1 study · 24 participants
GRADE not reported

Pilocarpine vs no treatment/placebo

Quality of life (McMaster HNRQ, 1-7 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

It is very uncertain whether pilocarpine changes quality of life (McMaster HNRQ, 1-7 scale) 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 6 months postRT
MD 0.20 [-0.19, 0.59]
1 study · 90 participants
Very low

Amifostine vs no treatment/placebo

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

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