1099P - Radiotherapy related xerostomia in head and neck oncology: A systematic review

Abstract

Background: Radiotherapy in the head and neck region can lead to salivary gland hypofunction and as a result dry mouth ensues. We have undertaken this systematic review and meta-analysis to estimate the effectiveness of available interventions for radiotherapy-induced xerostomia and hyposalivia. Methods: A systematic review and meta-synthesis techniques were adopted to identify, appraise and synthesize the relevant literature regarding the experience of nutritional symptoms of HNC patients conducted according to the PRISMA guidelines. Several electronic databases such as PubMed, CINAHL, Scopus, PsycINFO and the Cochrane Library databases were searched. Results: 1598 patients from Eighteen studies were included in the systematic review. Cholinergic agonists like Pilocarpine, cevimeline and bethanechol were tested in most studies. Other drugs tested include malic acid, physostigmine, specific monoclonal antibodies like Rituximab, fluoroquinolones, saliva substitutes/mouthcare systems, hyperthermic humidification, acupuncture, acupuncture-like transcutaneous electrical nerve stimulation, low-level laser therapy and herbal medicine. A recent study evaluated the salivary parameters in 4 phases. Results of meta analysis suggests cholinergic agonists were the most effective to improve salivary flow, compared to placebo, although some aspects of the relevant effect size, duration of the benefit, and clinical meaningfulness remain unclear. Conclusions: Pilocarpine, bethanechol and cevimeline should represent the first line of therapy in head and neck cancer survivors with radiotherapy-induced xerostomia and hyposalivation. The use of other treatment modalities cannot be supported on the basis of current evidence. Legal entity responsible for the study: nil Funding: None Disclosure: All authors have declared no conflicts of interest.