Guidelines for Complications of Cancer Treatment Vol VIII Part B

RTOG, EORTC and CTCAE, version 3 for scoring ofxerostomia (CoxJD et al., Trotti A et al.).All these evaluations are carried out both pre and post treatmentand at regular intervals thereafter to estimate the damage andevaluate recovery, if any.Prevention & treatmentBest method to treat xerostomia is to prevent it. Good andappropriate attention to dental prophylaxis prior toradiotherapy is mandatory. Aggressive measures attending tomaintenance of oral hygiene during and after treatment areessential in preventing the sequelae to xerostomia.Pharmacologic agents: Fluoride agents to maintain optimal oral hygiene:0.4% stannous fluoride gel to minimize dentalcaries (Chambers MS et al.). Antimicrobials to prevent dental caries and oralinfection. Saliva substitutes like carboxymethyl cellulose.Have moistening and lubricating properties,provide prolonged wetness of the oral mucosa andmay provide palliation by providing wetness torelieve discomfort (LOE 2). Sialogogues that stimulate saliva production Pilocarpine: Is the only sialogogic agent approvedby the FDA for radiation induced xerostomia.Studies have shown pilocarpine to have efficacyin patients with radiation induced xerostomia(LOE 1).Data from a randomized RTOG trial (ScrantinoCW et al.) suggest that there is some improvementin objective saliva measurements in patientsreceiving pilocarpine during radiation as compared169