Guidelines for Complications of Cancer Treatment Vol VIII Part B

170to those that received placebo. However there wasno difference in the patient’s perception ofxerostomia for patients receiving pilocarpine whencompared to the placebo arm. In two trialsconducted by Johnson and colleagues and LeVequeet al., significantly more patients treated withpilocarpine reported an improvement in xerostomiaas compared to the control group. In addition inthe study by LeVeque, there was a decrease in theuse of oral comfort agents in patients treated withpilocarpine.Based on the results of randomized trials theCCOPG (Cancer Care Ontario PracticeGuidelines) arrived at a few suggestions regardingthe use of Pilocarpine in patients on radiotherapy,suffering from post radiotherapy xerostomia,provided there are no medical contra-indicationsto the use of pilocarpine. (2.5 – 10mg, bid or tiddosage). The exact duration of treatment is notknown. Other cholinergic agents with sialogogicproperties.Cevimeline - Studies are ongoing to evaluate its efficacy inxerostomia in Sjogrens’ syndrome.Radioprotectors like Amifostine:The FDA has approved the use of Amifostine forprevention of xerostomia in patients undergoingradiotherapy for the head and neck region. Thisrecommendation was based on the results of a phase IIIrandomized trial conducted by Brizel et al., whichrevealed that there was a decrease in the incidence ofGrade 2 or higher chronic xerostomia from 57% to 34%in patients receiving amifostine. Also, there was no