DETERMINATION OF THE EFFICACY OF TOPICAL ORAL PILOCARPINE FOR POSTIRRADIATION XEROSTOMIA IN PATIENTS WITH HEAD AND NECK-CARCINOMA

Pilocarpine hydrochloride suspended in a candy-like pastille was evalu ated as a topical treatment for radiation-induced xerostomia in head a nd neck cancer patients. This local delivery system, which differs fro m systemically administered pilocarpine preparations, was developed to hopefully maximize the local response and minimize the systemic side effects. A prospective, randomized, double-blind, placebo-controlled t rial was undertaken to determine objective and subjective efficacy in reversing the decrease in salivation. Forty previously irradiated pati ents received increasingly higher pilocarpine dosages in pastilles for 5 successive weeks. At each successive dose of pilocarpine, no signif icant increased salivation was noted. However, 25 (74%) of 34 patients reported that pilocarpine alleviated their subjective xerostomia. Top ical pilocarpine administration has shown similar results to previous systemic delivery methods for radiation-induced xerostomia, but with i mproved patient tolerance.