Randomized double blind, placebo-controlled study of pilocarpine administered during head and neck irradiation to reduce xerostomia.

PURPOSE: Pilocarpine hydrochloride administered during head and neck irradiation was evaluated for its ability to relieve xerostomia and its adverse effects. MATERIAL AND METHOD: A total of 60 head and neck cancer patients were enrolled in a randomized, double blind, placebo-controlled trial. Each patient had both parotid glands treated with a radiation dose of at least 50 Gy. Patients received jelly containing pilocarpine or placebo 5.0 mg (1 cc.) tid at meal times during radiation. Pilocarpine was administered beginning on the first day of radiation and continued until radiation was completed. Patients were evaluated for symptomatic relief by responding to questionnaires using a Visual Analogue Scale (VAS). Questionnaires measured relief of oral dryness, oral discomfort, difficulty in chewing and swallowing, speaking, and sleeping. Evaluation was conducted preradiation as a baseline, weekly during radiation and monthly until 6 months after radiation was completed. RESULTS: The baseline characteristics, disease and radiation technique including field arrangement and total dose, were not significantly different between the two groups. There was no statistically significant subjective difference in xerostomia, including oral dryness, oral discomfort, inability to chew and swallow, speak and sleep, during and postradiation between the two groups. The adverse effects were non-specific symptoms such as nausea, vomitting, dizziness, urinary frequency, palpitation, sweating and tearing. The adverse effects during radiation and postradiation were not significantly different between the two groups. CONCLUSION: It was concluded that pilocarpine hydrochloride administered during head and neck irradiation produced subjectively insignificant benefit in relieving xerostomia with acceptable side effects.

Cancer incidence in Songkhla, southern Thailand, 1990-1994.

A population-based cancer registry of Songkhla was established by the Cancer Unit of Songklanagarind Hospital under the support of the IARC in 1990. The province is in the southern region of Thailand and has a population of 1.2 million. This study presents the average annual incidence rate of the provincial total and of the district level covering 1990-1994. It is aimed at providing a comprehensive picture of descriptive epidemiology of cancer in the province. Data were collected from all hospitals in the provinces. Analysis was done under the program provided by IARC. There were 3,973 invasive cancer cases in the period. The age-standardized rate for all cancers was 116.7 in males and 88.7 in females. Lung, oral cavity, liver, and esophagus were the main leading sites in males while the cervix and breast were outstanding in females. By comparison, the incidence of most cancers were lower than other registries in Thailand except for two cancer sites. The incidence of male oral cavity and esophagus cancers in males (ASR 10.7 and 8.5 respectively) were considerably higher. Na Mom, Hat Yai, Sadao and Muang were districts having a high incidence of cancer.