Serviços Personalizados
Journal
Artigo
Indicadores
- Citado por SciELO
- Acessos
Links relacionados
- Similares em SciELO
Compartilhar
Revista odontológica mexicana
versão impressa ISSN 1870-199X
Rev. Odont. Mex vol.12 no.3 Ciudad de México Set. 2008
https://doi.org/10.22201/fo.1870199xp.2008.12.3.15668
Trabajos originales
Respuesta terapéutica de la pilocarpina en relación a la xerostomía inducida por radioterapia
Therapeutics response of pilocarpine related to xerostomy induced by radiotherapy
* Profesora de la Asignatura de Cirugía Bucal y Maxilofacial, División de Estudios Profesionales, FO UNAM.
§ Alumna de la Asignatura de Cirugía Bucal y Maxilofacial.
II Adscritos al Instituto Nacional de Cancerología, México.
¶ Profesor de Estadística de la División de Estudios de Postgrado, FO UNAM.
El objetivo del estudio fue evaluar la respuesta de la pilocarpina en la xerostomia inducida por radioterapia en cabeza y cuello. El diseño de estudio fue descriptivo, prospectivo de corte longitudinal, doble ciego. Los pacientes se distribuyeron aleatoriamente en dos grupos. El grupo 1 (n = 10) de control recibió placebo. Al grupo 2 (n = 10) de estudio se le administró 5 mg diarios de pilocarpina cada 8 h por vía oral. Se realizaron tres cuantificaciones del flujo salival; al inicio del tratamiento, a la quinta y a la séptima semana, por el método de diferenciación de pesos. En la primera cuantificación, al inicio del tratamiento de radioterapia, los pacientes no habían recibido ningún tipo de medicamento, en ningún grupo. Comparando ambos grupos se obtuvo t = 0.525, Ρ = 0.606, por lo que no existía diferencia estadísticamente significativa, en el flujo salival. A la quinta semana se observó en ambos grupos disminución del flujo salival, comparándolos se obtuvo t = 0.481, Ρ = 0.636, por lo que no se encontró diferencia estadísticamente significativa. Sin embargo, el grupo de estudio tuvo un incremento estadísticamente significativo a la séptima semana , del flujo salival, donde se obtuvo una media 0.651 y d.s 0.380, mientras el grupo control mostró una media 0.256, d.s 0.251 al aplicar una t de student se obtuvo t = 2.743, ρ = de 0.013. Concluyendo que la pilocarpina es un tratamiento alternativo, viable, seguro y econòmico, para la xerostomia inducida por radioterapia.
Palabras clave: Xerostomía; pilocarpina
The objective of this study was to evaluate the response of pilocarpine in patients with xerostomy induced by radiotherapy in head and neck. Twenty patients of the Instituto Nacional de Cancerologia (INCan) participated. A randomized, prospective and longitudinal study was carried out. The control group (n = 10) received a placebo. The study group (n = 10) was medicated daily with 5 mg of pilocarpine every 8 hours. Salivary flux was quantified three times: at the beginning of the treatment, at the fourth and at the seventh week. The quantification was realized by the mass difference method. When the first quantification was carried out at the beginning of radiotherapy treatment, no patient had received medication. Comparing both groups we obtained t = 0.525, p = 0.606, so that there was no statistically significant difference in salivary flux. In the fifth week a reduction of salivary flux in both groups was observed, when the groups were compared there was no statistically significant difference between them (t = 0.481, p = 0.636). In the seventh week a significative increment in salivary flux in the study group compared with the control group was observed. For the study group the values were: mean = 0.651 and standard deviation = 0.380, while for the control group the values were: mean = 0.256 and standard deviation = 0.251. By comparing the groups with t-Student test, the results were: t = 2.743, ρ = 0.013. It is concluded that pilocarpine is an alternative, viable, safe and economic treatment for xerostomy induced by radiotherapy.
Key words: Xerostomy; pilocarpine
REFERENCIAS
1. Davies AN, Singer JM. A comparison of artificial saliva and pilocarpine in radiation induced xerostomia. J of Laringology and Otology 1994; 108: 663-65. [ Links ]
2. Rhodus L, Schuh MJ. Effects of pilocarpine on salivary floor in patients with Sjögre'n syndrome. Oral Surgery Oral Medicine Oral Patholoy 1991; 72: 545-9. [ Links ]
3. Davis AN. A comparison of artificial saliva and chewing gum in the management of xerostomia in patients with advanced cancer. Palliative Medicine 2000; 14: 197-203. [ Links ]
4. Seikaly H, Jha N, McGaw T et al. Submandibular gland transfer: a new method of preventing radiation-induced xerostomia. Laryngoscope 2001; 111 (2): 347-52. [ Links ]
5. Johnstone PA, Peng YPP, May BC, Inouye WS, Nietmtzow RC. Acupuncture for pilocarpine-resistant xerostomia following radiotherapy for head and neck malignancies. Int J Radiat Oncol Biol Phys 2001; 50: 53-357. [ Links ]
6. Ingrid VH, Wolf, Alkinson, Jane C, Macnsk A, Fox P. Use of pilocarpine during head and neck radiation therapy to reduce xerostomia and salivary dysfunction. Cancer 1993; 71: 663-65. [ Links ]
7. Fisher J, Scott C, Scarantino CW. et al. Phase III quality-of-life study results: Impact on patients' quality of life to reducing xerostomia after radiotherapy for head-and-neck cancer- RTOG 97-09. Int J Radiat Oncol Biol Phys 2003; 56(3) : 832-6. [ Links ]
8. Jonson JT, Ferretti GA, Nethery WJ, Ingrid HV, Fox PhC, David NG, Muscoplant CC, Gallagher SC. Oral pilocarpine for post-irradiation xerostomia in patients with head and neck cancer. The New England Journal of Medicine 1993; 329: 390-395. [ Links ]
9. Wiseman L, Faulds D. Oral pilocarpine. A review of its pharmacological properties and clinical potential in xerostomia. Adis International Limited 1992; 49: 143-155. [ Links ]
10. Shigaki SK, Tsutomo N, Tamio N. The role of radiotherapy in the management of salivary glands carcinomas. J of Cranio-Maxillo-Facial Surgery 1992; 20: 220-24. [ Links ]