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The influence of pilocarpine and biperiden on pH value and calcium, phosphate, and bicarbonate concentrations in saliva during and after radiotherapy for head and neck cancer

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The influence of pilocarpine and biperiden on pH value and calcium, phosphate, and bicarbonate concentrations in saliva during and after radiotherapy for head and neck cancer

Auteurs : Mirela Rode [Slovénie] ; Lojze Šmid [Slovénie] ; Marjan Budihna [Slovénie] ; Dominik Gašsperšsi [Slovénie] ; Matjaž Rode [Slovénie] ; Erika Šoba [Slovénie]

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RBID : ISTEX:E085E3227D6F75AF22D0287665398E4FD0607BB7

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Abstract

Abstract: Objective: The purpose of the present study was to investigate the influence of parasympathomimetic pilocarpine and anticholinergic biperiden on salivation, pH value, and calcium, phosphate, and bicarbonate concentrations in saliva in patients irradiated for malignant tumors of the head and neck region. Study Design: Sixty-nine patients were randomly assigned into 3 groups. Group A consisted of patients receiving pilocarpine, group B of those who were receiving biperiden during radiotherapy and pilocarpine for 6 weeks after its completion, and group C comprised patients receiving neither of the mentioned drugs. The quantity of secreted unstimulated saliva, its pH value, as well as calcium, phosphate, and bicarbonate concentrations in saliva were measured before the beginning of radiotherapy, after 30 Gy of irradiation, at completed irradiation, and 3, 6, and 12 months after completion of radiotherapy. Results: Saliva secretion was found to be the least affected in the group of patients receiving biperidene throughout the course of radiotherapy. One year after completion of therapy, the quantity of secreted saliva could only be measured in the patients receiving biperiden during radiotherapy; it amounted to 16% of the average initial quantity of saliva secreted before the beginning of irradiation. In all 3 groups of patients, mean pH value decreased during radiotherapy and started to increase again after completion of irradiation. In group B the decrease in pH value after radiotherapy was statistically significantly smaller than that in group C (P =.01). During and after irradiation, calcium concentration was increased in all 3 groups of patients. Phosphate concentration decreased during radiotherapy in all 3 groups. In group B it started to increase again 3 months after completion of radiotherapy. Bicarbonate concentration showed a slight increase during radiotherapy and started to decrease again after completion of irradiation. Conclusion: The results of our study indicate that the inhibition of saliva secretion during radiotherapy and its stimulation after completion of treatment can contribute not only to some preservation of the quantity of saliva but also to at least partial preservation of its quality in terms of pH value and calcium, phosphate, and bicarbonate concentrations.(Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92:509-14)

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DOI: 10.1067/moe.2001.115984

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<term>Bicarbonate</term>
<term>Bicarbonate concentration</term>
<term>Bicarbonate concentrations</term>
<term>Biol</term>
<term>Biperiden</term>
<term>Calcium concentration</term>
<term>Control group</term>
<term>Flow rate</term>
<term>Former value</term>
<term>Gland function</term>
<term>Irradiation damage</term>
<term>Ljubljana</term>
<term>Malignant tumors</term>
<term>Neck cancer</term>
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<term>Oral surg</term>
<term>Oral surgery</term>
<term>Parasympathomimetic pilocarpine</term>
<term>Parotid</term>
<term>Particular groups</term>
<term>Pathology november</term>
<term>Phosphate concentration</term>
<term>Pilocarpine</term>
<term>Radiotherapy</term>
<term>Saliva</term>
<term>Saliva secretion</term>
<term>Salivary</term>
<term>Salivary calcium concentration</term>
<term>Salivary glands</term>
<term>Salivation</term>
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<term>Bicarbonate</term>
<term>Bicarbonate concentration</term>
<term>Bicarbonate concentrations</term>
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<term>Biperiden</term>
<term>Calcium concentration</term>
<term>Control group</term>
<term>Flow rate</term>
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<term>Oral surg</term>
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<term>Parasympathomimetic pilocarpine</term>
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<term>Particular groups</term>
<term>Pathology november</term>
<term>Phosphate concentration</term>
<term>Pilocarpine</term>
<term>Radiotherapy</term>
<term>Saliva</term>
<term>Saliva secretion</term>
<term>Salivary</term>
<term>Salivary calcium concentration</term>
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<div type="abstract" xml:lang="en">Abstract: Objective: The purpose of the present study was to investigate the influence of parasympathomimetic pilocarpine and anticholinergic biperiden on salivation, pH value, and calcium, phosphate, and bicarbonate concentrations in saliva in patients irradiated for malignant tumors of the head and neck region. Study Design: Sixty-nine patients were randomly assigned into 3 groups. Group A consisted of patients receiving pilocarpine, group B of those who were receiving biperiden during radiotherapy and pilocarpine for 6 weeks after its completion, and group C comprised patients receiving neither of the mentioned drugs. The quantity of secreted unstimulated saliva, its pH value, as well as calcium, phosphate, and bicarbonate concentrations in saliva were measured before the beginning of radiotherapy, after 30 Gy of irradiation, at completed irradiation, and 3, 6, and 12 months after completion of radiotherapy. Results: Saliva secretion was found to be the least affected in the group of patients receiving biperidene throughout the course of radiotherapy. One year after completion of therapy, the quantity of secreted saliva could only be measured in the patients receiving biperiden during radiotherapy; it amounted to 16% of the average initial quantity of saliva secreted before the beginning of irradiation. In all 3 groups of patients, mean pH value decreased during radiotherapy and started to increase again after completion of irradiation. In group B the decrease in pH value after radiotherapy was statistically significantly smaller than that in group C (P =.01). During and after irradiation, calcium concentration was increased in all 3 groups of patients. Phosphate concentration decreased during radiotherapy in all 3 groups. In group B it started to increase again 3 months after completion of radiotherapy. Bicarbonate concentration showed a slight increase during radiotherapy and started to decrease again after completion of irradiation. Conclusion: The results of our study indicate that the inhibition of saliva secretion during radiotherapy and its stimulation after completion of treatment can contribute not only to some preservation of the quantity of saliva but also to at least partial preservation of its quality in terms of pH value and calcium, phosphate, and bicarbonate concentrations.(Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92:509-14)</div>
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