Abstract
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.
Highlights
The radiotherapy (RT) is indicated as primary, adjuvant to surgery, or palliative therapy for tumors in the head and neck region [1]
A total of 15 patients did not complete all Phases of the study (Table 1). - Xerostomia evaluation: During Phase 1, most of the patients had severe XT (93.3%); only 3 patients (6.7%) presented XT Grade 1
Recently, our group demonstrated the benefits of bethanechol chloride (BC) used as prophylactic therapy to prevent radiotherapyinduced XT, mainly in patients treated with IMRT
Summary
The radiotherapy (RT) is indicated as primary, adjuvant to surgery, or palliative therapy for tumors in the head and neck region [1]. 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]. Few studies have demonstrated the benefits of BC for treating salivary gland hypofunction in patients previously submitted radiotherapy in the head and neck regions. The aim of this study was to evaluate the effect of BC therapy on XT, hyposalivation and saliva composition in head and neck irradiated patients. 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. Conclusions: Our 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
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