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Radiation Induced Xerostomia & Pilocarpine

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Kidwai Memorial Institute of Oncology, Bangalore
Kidwai Memorial Institute of Oncology, Bangalore
Health & Medicine
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RADIATION INDUCED XEROSTOMIA & ORAL PILOCARPINE Dr. V. Lokesh M.D Radiation Oncologist Kidwai memorial Institute of Oncology, Bangalore, India.
Physiology of Salivary Secreation ,[object Object],[object Object],[object Object]
 
 
[object Object],[object Object],[object Object],[object Object]
 
Mechanism of Stimulus ,[object Object],[object Object]
 
Functions of Saliva ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
RADIATION INDUCED XEROSTOMIA ,[object Object],[object Object],[object Object],[object Object]
XEROSTOMIA DURING RADIATION THERAPY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Samuel Dreizen 38: 273-278, 1976
Salivary Electrolytes in Radiation Xerostomia
 
 
 
 
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Abraham Kuten Int Jr Rad Oncol Biol Phys Vol:12,401-405,1985
 
Feeling of Dryness of Mouth
Salivary flow rates during RT
Na + concentration during RT
Deterioration in Taste acuity
Dysphagia during RT
Candida during RT
1000-2000cGy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
XEROSTOMIA RELATED MORBIDITY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Most effective intervention for Xerostomia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ORAL PILOCARPINE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Ferguon et al , 1890. Recognised use of pilocarpine for Xerostomia
Oral Pilocarpine in Salivary Dysfunction Stimulated & Unstimulated : Significant Increase in Secreation
POST RT - XEROSTOMIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Jona T. Johnson, The NEJM Aug 05, 1993
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Effect of Oral Pilocarpine on Symptom of Post RT Xerostomia
Improvement in salivary function
Effect of Oral Pilocarpine production of whole saliva and unstimulated Parotid Saliva
Incidence of Adverse events
[object Object],[object Object],[object Object],[object Object],[object Object]
French Co-operative Study ,[object Object],[object Object],[object Object],[object Object],[object Object],J.C.Horiot . Radiotherapy and Oncology, 55 , 233-239, 2000
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
 
 
CONCURRENT AND ADJUVANT ORAL PILOCARPINE Ingrid H. Valdez, Cancer Medicine, 1993, Vol 71, No:5
Double Blind, Placebo controlled ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Retospective Analysis ,[object Object],[object Object],[object Object],Robert P. Zimmerman, Int Jr Rad Oncolo, Bio Phy, Vol 37, No:3, 1996
 
 
 
Randomised, Double Blind, Placebo Controlled Trial ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Pieman Haddad, Radiotherapy & Oncology, 64, (2002)
Use of Pilocarpine During RT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Maximun Tolerance Dose TD 50/5 ,[object Object],Mossman Int J Rad Oncol Biol & Phy Vol:8,991-997,1982
CONCLUSIONS ,[object Object],[object Object],[object Object]
THANK YOU

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