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Systematic literature review: xerostomia in advanced cancer patients

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Abstract

Purpose

Dry mouth (xerostomia) is one of the commonest symptoms in cancer patients and can adversely affect quality of life. The aim of this review was to determine the effectiveness of pharmacological and non-pharmacological interventions in treating xerostomia in adult advanced cancer patients.

Methods

The literature search was performed in February 2014 using databases including EMBASE, MEDLINE, CINAHL, BNI and Cochrane library. The search was carried out using standard MeSH terms and was limited to adult population and English language. Studies investigating xerostomia secondary to head and neck cancer treatment and autoimmune disease were excluded. Titles and abstracts were screened and reviewed for eligibility. Only studies involving primary research were included in the analysis.

Results

Six studies met the eligibility criteria for review: three randomized controlled trials and three prospective studies. The quality assessment and reporting was performed using PRISMA, Jadad and STROBE. These studies compared acupuncture, pilocarpine, Saliva Orthana and chewing gum with each other or with placebo. All interventions were considered effective in treating xerostomia. However, effectiveness versus placebo could not be demonstrated for Saliva Orthana. Meta-analysis could not be performed due to heterogeneity of the study type and intervention.

Conclusion

Limited published data exists reporting the effectiveness of measures in the treatment of xerostomia in cancer patients. Based on primary research of low quality, firm conclusions cannot be drawn. However, pilocarpine, artificial saliva, chewing gum and acupuncture can be tried based on the available data. This highlights the explicit need to improve our evidence base. Properly constructed randomized controlled trials demonstrating effectiveness of pharmacological and non-pharmacological interventions for dry mouth are required.

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Acknowledgments

The authors would like thank Jenny Makeham, corporate support librarian at Leeds General Infirmary, for performing the database literature search and Dr. Amy Gadoud for reviewing the manuscript.

Conflict of interest

We declare that we do not have any conflict of interest.

Author information

Authors and Affiliations

  1. Yorkshire Deanery, Leeds, West Yorshire, UK

    Sarika Hanchanale, Lucy Adkinson, Sunitha Daniel & Michelle Fleming

  2. Kirkwood Hospice, Huddersfield, West Yorshire, UK

    Stephen G Oxberry

Authors
  1. Sarika Hanchanale
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  2. Lucy Adkinson
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  3. Sunitha Daniel
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  4. Michelle Fleming
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  5. Stephen G Oxberry
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Corresponding author

Correspondence to Sarika Hanchanale.

Appendix

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Table 3 Excluded literature
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Hanchanale, S., Adkinson, L., Daniel, S. et al. Systematic literature review: xerostomia in advanced cancer patients. Support Care Cancer 23, 881–888 (2015). https://doi.org/10.1007/s00520-014-2477-8

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