Post-radiation severe xerostomia relieved by pilocarpine:: a prospective French cooperative study

Post-radiation severe xerostomia relieved by pilocarpine:: a prospective French cooperative study
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DOI:
10.1016/s0167-8140(99)00018-3
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发表时间:
2000-06-01
影响因子:
5.7
通讯作者:
Maral, J
Maral, J
中科院分区:
医学1区
文献类型:
--
作者:
Horiot, JC;Lipinski, F;Maral, J

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背景与目的:本研究的目的是:(1)证实盐酸匹洛卡品(Salagen)对口干症的治疗作用;(2)与放疗剂量/体积参数的相关性。材料和方法:从1995年6月到1996年2月,156例严重放射性口干症患者口服盐酸匹罗卡品,每天15mg,在5周内可选择增加5mg,直至9周后每天25mg。结果:145例患者可完全评估。治疗依从性为75%。38名患者(26%)在第12周前因急性不耐受(出汗、恶心、呕吐)或无反应而停止治疗。无严重并发症发生。97名患者(67%)报告在12周时口干症状明显缓解。在12周内,正常食物摄入亚组的规模几乎翻了一番(13-24例),而(几乎)不可能摄入固体食物的亚组的规模减少了38%(47例对29例)。77%的应答者认为对生活质量的影响是重要或非常重要的。结论:剂量/体积放疗参数无差异,提示口服盐酸匹洛卡品:(1)主要通过刺激小唾液腺起作用;(2)无论放疗剂量/体积参数如何,对严重口干症患者都有益处;(3)在12周时确定所有应答者。(C) 2000爱思唯尔科学爱尔兰有限公司版权所有。
Background and purpose: The aim of the study was: (1) to confirm the action of pilocarpine hydrochloride (Salagen) against xerostomia; (2) to correlate the response to dose/volume radiotherapy parameters.Materials and methods: From June 1995 to February 1996, 156 patients with severe radiation induced xerostomia received pilocarpine hydrochloride orally, 15 mg per day with a 5 mg optional increase at 5 weeks up to a daily dose of 25 mg beyond 9 weeks.Results: One hundred and forty five patients ale fully evaluable. Treatment compliance was 75%. Thirty eight patients (26%) stopped treatment before week 12 for acute intolerance (sweating, nausea, vomiting) or no response. No severe complication occurred. Ninety seven patients (67%) reported a significant relief of symptoms of xerostomia at 12 weeks. Within 12 weeks, the size of the subgroup with normal food intake almost doubled (13-24 patients) while the size of the subgroup with (nearly) impossible solid food ingestion decreased by 38% (47 vs. 29 patients). The impact on quality of life was considered important or very important by 77% of the responders.Conclusions: No difference was found according to dose/volume radiotherapy parameters suggesting that oral pilocarpine hydrochloride: (1) acts primarily by stimulating minor salivary glands; (2) can be of benefit to patients suffering of severe xerostomia regardless of radiotherapy dose/volume parameters: (3) all responders are identified at 12 weeks. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.