A randomized study to assess the effectiveness of orally administered pilocarpine during and after radiotherapy of head and neck cancer.

BACKGROUND: This prospective randomized study was undertaken to assess the effectiveness of oral pilocarpine chloratum (Salagen) during and after radiotherapy. PATIENTS AND METHODS: Between October 1999 and December 2003, 66 patients received 60 Gy of irradiation to their head and neck cancer. Half of the patients received 5 mg oral pilocarpine 3 times a day from the beginning of radiotherapy over a period of 12 weeks. The control group received similar doses of pilocarpine only in the second 6 weeks following irradiation. Patient saliva secretion was recorded, and a visual analog scale measuring overall and daily xerostomia, difficulty in sleeping, speaking, eating and wearing dentures was employed. RESULTS: Pilocarpine, given concomitantly with radiotherapy, statistically improved the salivary flow and induced better patient comfort by the end of radiotherapy. Patient comfort and symptoms related to xerostomia greatly decreased compared to patients receiving pilocarpine after irradiation in the second 6-week period of therapy. The patients' quality of life, saliva production and symptoms related to xerostomia showed significant progress by the end of the 12 weeks. CONCLUSION: The results suggest that stimulated salivary glands suffer less decrease in saliva production during radiotherapy. The stimulated saliva flow reduced the side-effects of irradiation.

[The effectiveness of a benzydamine rinse in the management of stomato-glossopyrosis]. / Benzidamin-tartalmú szájöblítovel szerzett klinikai tapasztalatok a stomato- glossopyrosis kezelésében.

Burning mouth syndrome (BMS) is a frequent source of oral discomfort and sensation mainly at middle-aged or elderly women without identifiable local pathology. Forty-two patients with stomato-glossopyrosis were registered at the Department of Periodontology, Dental School, University Pécs, between August 2002 and January 2003. Oral clinical examination failed to identify physical explanation for the complaint of painful or burning mouth. After complete examination (blood test included), scaling, root planning and oral hygiene instructions were given. Six patients reported decreasing mucosal pain or burning. Two patients had iron-deficiency and Sjögren's syndrome was suspected and verified at another two patients. Thirty-two patients completed the benzydamine-study. They were divided into two groups. The study group (16 patients) rinsed with benzydamine containing solution, the control group (16 patients) received placebo solution for rinsing the same way for ten days. Differences were found between the two groups favouring the benzydamine containing solution. Pain reduction, mouth dryness and diminution of burning sensation were detected by means of visual analog scale (VAS). Benzydamine rinses could be effective in the management of BMS, but clinicians need to monitor patients for possible side effects in the case of long-term use.