Double blind randomized prospective trial of bethanechol in the prevention of radiation-induced salivary gland dysfunction in head and neck cancer patients

Jaguar, Graziella Chagas; Lima, Eduardo Nóbrega Pereira; Kowalski, Luiz Paulo; Pellizzon, Antônio Cássio Assis; Carvalho, André L.; Boccaletti, Karina Waiswol; Alves, Fábio Abreu

doi:10.1016/j.radonc.2015.03.017

Cited by 36 publications

(41 citation statements)

References 18 publications

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“…The prophylactic use of systemic sialogogues for radiationinduced xerostomia is widely reported in the literature [28][29][30][31][32][33][34][35][36]. These drugs are defined as systemic stimulants of salivary gland function by acting directly on the parasympathetic nervous system [19].…”

Section: Systemic Sialogoguesmentioning

confidence: 99%

“…Our group, in Jaguar et al study [36], assessed the prophylactic bethanechol effect in a prospective doubleblind setting in order to reduce or ameliorate xerostomia and hyposalivation. A total of 97 head and neck cancer patients were allocated into two groups: Bethanechol (n = 48) or Placebo (n = 49).…”

Section: Bethanechol Chloridementioning

confidence: 99%

“…Based on our experience and published researches [36,57,58], we could establish a xerostomia prevention protocol, as follow:…”

Section: Ac Camargo Cancer Center Protocol For Xerostomia Preventionmentioning

confidence: 99%

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Clinical features and preventive therapies of radiation-induced xerostomia in head and neck cancer patient: a literature review

et al. 2017

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Xerostomia or dry mouth is one of the most common and disturbing adverse effects following radiotherapy for head and neck cancer (HNC). This complication strongly increases the risk for dental caries, difficulties with chewing, swallowing and sleep disorders with significant impact on patients' quality of life. Current treatment approaches of xerostomia are often difficult and bring in many cases no substantial relief for the patient. This paper discusses the clinical features and current knowledge of xerostomia prevention in order to evaluate the real possibilities of reducing the incidence and severity of this complication in HNC patients. Salivary gland cytoprotectants (amifostine), muscarinic agonist stimulation (pilocarpine and bethanechol), salivary gland-sparing radiation technique (intensity-modulated radiotherapy-IMRT), surgical relocation of the submandibular gland, intraoral stent and stem cell transplantation are promising techniques that are discussed in this study.

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Section: Systemic Sialogoguesmentioning

confidence: 99%

Section: Bethanechol Chloridementioning

confidence: 99%

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Clinical features and preventive therapies of radiation-induced xerostomia in head and neck cancer patient: a literature review

et al. 2017

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“…However, the secondary effects of the RT are a challenge to the professionals involved in the management of these patients. Oral mucositis; taste alterations; trismus; dental caries; progressive periodontal disease; osteoradionecrosis; hyposalivation and xerostomia (XT) are the main disturbing side effects related to head and neck RT (2). …”

Section: Introductionmentioning

confidence: 99%

“…Recently, our group, in a double-blind study, demonstrated that the prophylactic use of BC improved the salivary flow rate, XT symptoms and quality of life of patients submitted to radiotherapy (2). However, few studies have demonstrated the benefits of BC for treating salivary gland hypofunction in patients previously submitted radiotherapy in the head and neck regions.…”

Section: Introductionmentioning

confidence: 99%

Influence of bethanechol on salivary parameters in irradiated patients

et al. 2016

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BackgroundSome studies have shown evidence that the prophylactic use of bethanechol chloride (BC) may be useful in preventing the incidence and/or severity of xerostomia (XT). However, the indication of BC in irradiated patients with XT needs to be better characterized. The study aimed to evaluate the influence of BC on XT, salivary flow rate, and salivary composition in patients previously submitted to head and neck radiotherapy.Material and MethodsForty five irradiated patients complaining of XT used 50 mg/day of BC for 3 months, and the salivary parameters were evaluated in 4 Phases (Before BC therapy, after one month of BC, 2 months of BC, and 3 months of BC). Biochemical analysis included buffering capacity; pH; total protein concentration (TP); amylase concentration (AM); catalase (CAT) and peroxidase (PX) activities. In addition, unstimulated and stimulated salivary flow rates were determined and XT was classified.ResultsAccording to the XT grading system used, patients showed improvement in XT between Phase 1, and Phases 2, 3 and 4. In addition, some changes were observed in TP concentration (decreased); AM concentration (increased); and PX and CAT activities (decreased and increased, respectively) after Phase 2, for stimulated saliva collection (p<0.05).ConclusionsOur results suggested that when BC was used to treat salivary gland dysfunction induced by head and neck radiotherapy, improvement in XT symptoms, and some changes in saliva composition were shown. Key words:Radiotherapy, xerostomia, hyposalivation, saliva, biochemistry.

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Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy

Riley

Glenny

Hua

et al. 2017

Cochrane Database of Systematic Reviews

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There is some low-quality evidence to suggest that amifostine prevents the feeling of dry mouth in people receiving radiotherapy to the head and neck (with or without chemotherapy) in the short- (end of radiotherapy) to medium-term (three months postradiotherapy). However, it is less clear whether or not this effect is sustained to 12 months postradiotherapy. The benefits of amifostine should be weighed against its high cost and side effects. There was insufficient evidence to show that any other intervention is beneficial.

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Double blind randomized prospective trial of bethanechol in the prevention of radiation-induced salivary gland dysfunction in head and neck cancer patients

Cited by 36 publications

References 18 publications

Clinical features and preventive therapies of radiation-induced xerostomia in head and neck cancer patient: a literature review

Clinical features and preventive therapies of radiation-induced xerostomia in head and neck cancer patient: a literature review

Influence of bethanechol on salivary parameters in irradiated patients

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy

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