{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:02:33Z","timestamp":1790787753907,"version":"4.1.0"},"reference-count":97,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp;amp; Neck"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Xerostomia is highly prevalent among patients with head and neck cancer (HNC). This review aimed to compare the effectiveness of non\u2010pharmacological interventions (NPIs) for xerostomia among patients with HNC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched nine databases (inception\u2013October 2024) for RCTs assessing the effects of NPIs on xerostomia (self\u2010reported xerostomia, incidence, stimulated\/unstimulated salivary flow).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty\u2010six trials (3802 patients) identified 10 arms: multimodal NPIs, herbal medicine, acupuncture, exercise, oral care, devices, health education, supplements, and active\/passive controls. At post\u2010intervention, multimodal NPIs (the majority being herbal medicine combined with other therapies) ranked first for self\u2010reported xerostomia, incidence, and unstimulated flow versus other interventions. Herbal medicine ranked second for self\u2010reported and incidence of xerostomia and first for stimulated flow. Though lower\u2010ranked, acupuncture significantly improved all outcomes versus passive controls. Sensitivity analyses showed enhanced acupuncture efficacy with high\u2010dose radiotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Multimodal NPIs, herbal medicine, and acupuncture are promising for improving xerostomia among patients with HNC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70100","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T07:11:23Z","timestamp":1763622683000},"page":"302-316","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Non\u2010Pharmacological Interventions for Improving Xerostomia Among Patients With Head and Neck Cancer: A Systematic Review and Network Meta\u2010Analysis"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7510-7545","authenticated-orcid":false,"given":"Xueyan","family":"Cheng","sequence":"first","affiliation":[{"name":"Li Ka Shing Faculty of Medicine, School of Nursing The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5424-3705","authenticated-orcid":false,"given":"Lizhen","family":"Wang","sequence":"additional","affiliation":[{"name":"Li Ka Shing Faculty of Medicine, School of Nursing The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9443-4082","authenticated-orcid":false,"given":"Mu\u2010Hsing","family":"Ho","sequence":"additional","affiliation":[{"name":"Li Ka Shing Faculty of Medicine, School of Nursing The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4696-9434","authenticated-orcid":false,"given":"Shing Fung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology National University Cancer Institute  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7190-9025","authenticated-orcid":false,"given":"Frederick K.","family":"Ho","sequence":"additional","affiliation":[{"name":"School of Health and Wellbeing University of Glasgow  Scotland UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7980-3126","authenticated-orcid":false,"given":"Wing\u2010Fai","family":"Yeung","sequence":"additional","affiliation":[{"name":"School of Nursing The Hong Kong Polytechnic University  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9551-0991","authenticated-orcid":false,"given":"Chia\u2010Chin","family":"Lin","sequence":"additional","affiliation":[{"name":"Li Ka Shing Faculty of Medicine, School of Nursing The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8741-9271","authenticated-orcid":false,"given":"Denise Shuk Ting","family":"Cheung","sequence":"additional","affiliation":[{"name":"Li Ka Shing Faculty of Medicine, School of Nursing The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-015-2720-y"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-019-4650-6"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S70652"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2009.09.002"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20045"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2023.109715"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2015.09.014"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2015.11.012"},{"issue":"7","key":"e_1_2_11_10_1","article-title":"Pharmacological Interventions for Preventing Dry Mouth and Salivary Gland Dysfunction Following Radiotherapy","volume":"7","author":"Riley P.","year":"2017","journal-title":"Cochrane Database of Systematic Reviews"},{"issue":"14","key":"e_1_2_11_11_1","first-page":"1827","article-title":"Management of Xerostomia Related to Radiotherapy for Head and Neck Cancer","volume":"19","author":"Kahn S. 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