Abstract

MOSQUEDA TAYLOR, Adalberto et al. Effect of pilocarpine hydrochloride on salivary production in previously irradiated head and neck cancer patients. Med. oral patol. oral cir. bucal (Ed.impr.) [online]. 2004, vol.9, n.3, pp.204-211. ISSN 1698-4447.

Objective: To study the effects of pilocarpine hydrochloride on whole salivary gland production in Mexican patients affected by hyposalivation secondary to radiotherapy of the head and neck region. Study design: With previous written informed consent, 20 patients affected by hyposalivation secondary to head and neck radiation therapy (> 40Gy) were evaluated through the whole saliva test (WST) before, during and after ten weeks of treatment with pilocarpine hydrochloride (5 mg t.i.d.). Hyposalivation-related symptomatology was assessed before and at every week by means of a questionnaire with an ordinal scale ranging from 0-10. Salivary production values recorded at the end of the study and those obtained before treatment were compared by means of Student´s t test. A paired Wilcoxon test was used to compare the differences in the oral symptoms, such as oral dryness, soreness, ability for speaking and swallowing before and after treatment. Results: Initial WST had a mean salivary production of 0.8 cm (s.d. 0.7), with a range from 0 to 2.9 cm). After ten weeks of treatment salivary production increased to a mean of 2.24 cm (s.d. 0.7), with a range from 1.2 to 4.0 cm. There was a salivary flow increase of 64.5% (p<0.001). In addition, there were significant improvements in oral dryness, mouth comfort, ability to speak and ability to swallow (p<0.01). Adverse effects were usually minimal and they did not cause withdraw from the study in any case. Conclusions: Administration of 5-mg pilocarpine hydrochloride tablets three times daily significantly improved salivary production and clinical symptomatology secondary to radiation-induced hyposalivation with minimal side-effects. In addition, this study showed that WST is a fast, technically simple and highly reliable method to study salivary production in prospective studies.

Keywords : Pilocarpine; radiation; xerostomia; salivary glands; head and neck cancer.

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