{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:40:58Z","timestamp":1791492058289,"version":"4.3.4"},"reference-count":21,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T00:00:00Z","timestamp":1717027200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004776","name":"Faculty of Medicine, Chulalongkorn University","doi-asserted-by":"publisher","award":["GA66\/060"],"award-info":[{"award-number":["GA66\/060"]}],"id":[{"id":"10.13039\/501100004776","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to evaluate the efficacy of as\u2010needed pilocarpine for the management of radiation\u2010induced xerostomia. Additionally, the study sought to assess the side effects associated with an as\u2010needed regimen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A randomized, double\u2010blinded, placebo\u2010controlled crossover study was conducted on patients who had undergone radiation therapy for head and neck cancers and developed xerostomia. Participants took pilocarpine or placebo as needed for symptom relief at 2\u2009weeks per treatment, which included a one\u2010week washout period. The primary outcome measure was the severity of dry mouth symptoms, quantified using the Xerostomia Inventory (XI). The primary outcome was the change in the XI score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 20 participants who completed the crossover study, there was a significant reduction in XI scores during the treatment phase with pilocarpine compared to the scores during the placebo phase. The mean difference in XI scores was \u221218.05 (95% CI: \u221217.17, \u22126.13, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), with a\u221249.77\u2009\u00b1\u20093.22% change (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Only one participant withdrew due to pilocarpine side effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>As\u2010needed pilocarpine administration is effective in relieving symptoms of radiation\u2010induced xerostomia, with fewer side effects and reduced treatment costs compared to fixed\u2010dose regimens. This study guides the potential shift toward flexible dosing strategies in clinical practice, promoting enhanced patient\u2010centered, tailored care and adherence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2. According to the Oxford Center for Evidence\u2010Based Medicine 2011 level of evidence guidelines <jats:italic>Laryngoscope<\/jats:italic>, 134:4542\u20134548, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31544","type":"journal-article","created":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T10:35:32Z","timestamp":1717065332000},"page":"4542-4548","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["As\u2010Needed Pilocarpine for Radiation\u2010Induced Xerostomia in Head and Neck Cancers"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9303-0684","authenticated-orcid":false,"given":"Natcha","family":"Watanapokasin","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Faculty of Medicine Chulalongkorn University  Bangkok 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