Regular Article| Volume 39, ISSUE 1, P34-39, February 2001

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Prophylaxis of radiogenic sialadenitis and mucositis by coumarin/troxerutine in patients with head and neck cancer – a prospective,randomized, placebo-controlled, double-blind study

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      To study the efficacy of coumarin/troxerutine for the protection of salivary glands and mucosa during irradiation. Design: Prospective, randomized, placebo-controlled, double-blind trial. Setting: University hospital, Germany. Patients: 48 patients who had radiotherapy to the head and neck. Main outcome measures: Salivary gland scintigraphy and acute side-effects of radiotherapy (Radiation Therapy Oncology Group (RTOG) score). Results: 23 patients (11 experimental, 12 placebo) completed the study. The global efficacy measure combining scintigraphy and RTOG score favoured the experimental arm (P= 0.07). The RTOG score showed significantly fewer acute side-effects of radiation in the experimental arm (P< 0.05). Conclusion: The results suggest that coumarin/troxerutine have a favourable effect in the treatment of radiogenic sialadenitis and mucositis.
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        • Herrmann T
        • Jakubek A
        • Trott KR
        The importance of the timing of a gap in radiotherapy of squamous cell carcinomas of the head and neck.
        Strahlenther Onkol. 1994; 170: 545-549
        • Eichhorn W
        • Gehrke G
        • Bschorer R
        • Stepke M
        • Greschniok A
        Morphologische Veränderungen von kleinen Kopfspeicheldrüsen durch Strahlentherapie.
        Dtsch Zahnärztl Z. 1993; 48: 58-65
        • Shannon IL
        • Starcke EN
        • Wescott WB
        Effect of radiotherapy on whole saliva flow.
        J Dent Res. 1977; 56: 693
        • Matzker J
        • Schreiber J
        Synthetischer Speichel zur Therapie der Hyposialien, insbesondere bei der radiogenen Sialadenitis.
        Z Laryg Rhinol. 1972; 51: 422-428
        • Fox PC
        • Atkinson JC
        • Macynski AA
        Pilocarpine treatment of salivary gland hypofunction and dry mouth (xerostomia).
        Arch Intern Med. 1991; 151: 1149-1152
        • Greenspan D
        • Daniels TE
        Effectiveness of pilocarpine inpostradiation xerostomia.
        Cancer. 1987; 59: 1123-1125
        • Johnson JT
        • Ferretti GA
        • Nethery WJ
        Oral pilocarpine for post-irradiation xerostomia in patients with head and neck cancer.
        N Engl J Med. 1993; 329: 390-395
        • LeVeque FG
        • Montgomery M
        • Potter D
        A multicenter,randomized, double-blind, placebo-controlled, dose-titration study of oral pilocarpine for treatment of radiation-induced xerostomia in head and neck cancer patients.
        J Clin Oncol. 1993; 11: 1124-1131
        • Rhodus NL
        • Schuh MJ
        Effects of pilocarpine on salivary flow in patients with Sjogren's syndrome.
        Oral Surg Oral Med Oral Pathol. 1991; 72: 545-549
        • Schuller DE
        • Stevens P
        • Clausen KP
        • Olsen J
        • Gahbauer R
        • Martin M
        Treatment of radiation side effects with oral pilocarpine.
        J Surg Oncol. 1989; 42: 272-276
        • Markitziu A
        • Zafiropoulos G
        • Tsalikis L
        • Cohen L
        Gingival health and salivary function in head and neck-irradiated patients. A five-year follow-up.
        Oral Surg Oral Med Oral Pathol. 1992; 73: 427-433
        • Herberhold C
        • Ceynowa HJ
        Treatment of mouth drynessfollowing radiotherapy of head and neck tumors using Venalot.
        Ther Ggw. 1973; 112: 1622-1632
        • Beck-Steiner G
        Influencing of xerostomia and asialia duringpsychotropic drug therapy with benzopyrone.
        Munch Med Wochenschr. 1979; 121: 569-570
        • Hladovec J
        Vasotropic drugs – a survey based on a unifyingconcept of their mechanism of action.
        Drug Res. 1977; 27: 1073-1076
        • Baker D
        The radiobiological basis for tissue reactions in the oral cavity following therapeutic x-irradiation.
        Arch Otolaryngol. 1982; 108: 21-24
        • Bodner L
        • Kuyatt BL
        • Hand AR
        • Baum BJ
        Rat parotid cellfunction in vitro following x irradiation in vivo.
        Radiat Res. 1984; 97: 386-395
        • Witte PU
        • Schenk J
        • Schwarz A
        • Kori-Lindner C
        Ordnungsgemäße klinische Prüfung: Good clinical practice.
        Fürth: Habrich Fürth. 1990;
        • Makkonen TA
        • Nordman E
        Estimation of long-term salivary gland damage induced by radiotherapy.
        Acta Oncol. 1987; 26: 307-312
        • Seegenschmiedt MH
        • Sauer R
        The systematics of acute and chronic radiation sequelae.
        Strahlenther Onkol. 1993; 169: 83-95
        • Groetz KA
        • Menstell S
        • Weber L
        Diagnostic advances in salivary duct diseases.
        Zahnarztl Mitt. 1991; 81: 2482-2488
        • Kohn WG
        • Ship JA
        • Atkinson JC
        • Patton LL
        • Fox PC
        Salivary gland 99mTc-scintigraphy: a grading scale and correlation with major salivary gland flow rates.
        J Oral Pathol Med. 1992; 21: 70-74
        • Bohuslavizki KH
        • Brenner W
        • Lassmann S
        Quantitativesalivary gland scintigraphy derived from 166 normals.
        Radiol Oncol. 1995; 29: 297-305
        • Bohuslavizki KH
        • Brenner W
        • Lassmann S
        Quantitativesalivary gland scintigraphy – a recommended examination priorto and after radioiodine therapy.
        Nuklearmedizin. 1997; 36: 103-109
        • O'Brien PC
        Procedures for comparing samples with multiple endpoints.
        Biometrics. 1984; 40: 1079-1087
        • Lehmacher W
        • Wassmer G
        • Reitmeir P
        Procedures for two-sample comparisons with multiple endpoints controlling experimentwise error rate.
        Biometrics. 1991; 48: 511-521
        • Pyykönen H
        • Malmström M
        • Oikarinen VJ
        • Salmo M
        • Wehkalahti M
        Late effects of radiation treatment of tongue and floor-of-mouth cancer on the dentition, saliva secretion, mucousmembranes and the lower jaw.
        Int J Oral Maxillofac Surg. 1986; 15: 401-440
        • Bornemann C
        • Creutzig H
        Clinical significance of salivary gland scintigraphy. A prospective study.
        HNO. 1983; 31: 200-206
        • Cha IH
        • Ritzl F
        Funktionsszintigraphie der Kopdspeicheldrüsen im Verlauf einer Telekobalttherapie.
        Strahlentherapie. 1983; 159: 690-694
        • Riesenbeck D
        • Doerr W
        • Feyerabend T
        A Photographicdocumentation of acute radiation-induced side effects of theoral mucosa.
        Strahlenther Onkol. 1998; 174: 40-43
        • Doerr W
        • Doelling-Jochem I
        • Baumann M
        • Herrmann T h
        Therapeutische Beeinflussung der radiogenen oralen Mukositis.
        Strahlenther Onkol. 1997; 173: 183-192
        • Doerr W
        Radiobiological models of normal tissue reactions.
        Strahlenther Onkol. 1998; 174: 4-7
        • van der Vijgh WJ
        • Peters GJ
        Protection of normal tissues from the cytotoxic effects of chemotherapy and radiation by amifostine (Ethyol): preclinical aspects.
        Semin Oncol. 1994; 21: 2-7
        • Strnad V
        • Wannenmacher M
        • Brizel D
        Randomized phase III trial of radiation +/− amifostin in patients with head and neckcancer.
        Strahlenther Onkol. 1998; 174: 10
        • Koestering H
        • Bandura B
        • Merten HA
        • Wieding JU
        The behavior of blood clotting and its inhibitors under long-term treatment with 5,6-benzo-a-pyrone (coumarin)/Double-blind study.
        Drug Res. 1985; 35: 1303-1306
        • Joyston Bechal S
        • Hayes K
        • Davenport ES
        • Hardie JM
        Caries incidence, mutans streptococci and lactobacilli in irradiated patients during a 12-month preventive programme usingchlorhexidine and fluoride.
        Caries Res. 1992; 26: 384-390