***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Xerostomia is a common and usually irreversible side effects in patients receiving radiation therapy ( > 50 Gy ) for head and neck cancer . Of 38 patients with radiation-induced xerostomia , 20 in the experimental group were treated with classical acupuncture and 18 patients in the control group received superficial acupuncture as placebo . Within both groups the patients showed significantly increased salivary flow rates after the acupuncture treatment . In the experimental group 68 % and in the control group 50 % of the patients had increased salivary flow rates at the end of the observation period . Among those patients who had had all their salivary gl and s irradiated , 50 % in both groups showed increased salivary flow rates ( > 20 % ) by the end of the observation period of 1 year . The study indicates that among the patients who had increased salivary flow rates already after the first 12 acupuncture sessions , the majority had high probability of continual improvement after the completion of acupuncture treatment . The improved salivary flow rates usually persisted during the observation year . The changes observed in the control group were somewhat smaller and appeared after a longer latency phase . Significant differences for salivary flow rates could be observed only within each group , and there were no statistically significant differences between the groups . There were no differences in the improvement of salivary flow rates between those patients who were irradiated within a year before the acupuncture treatment and those who had received radiation therapy several years earlier . The results indicate that acupuncture might be a useful method for the treatment of radiation-induced xerostomia , and that superficial acupuncture should preferably not be used as placebo acupuncture PURPOSE To evaluate chronic xerostomia and tumor control 18 and 24 months after initial treatment with amifostine in a r and omized controlled trial of patients with head- and -neck cancer ; at 12 months after radiotherapy ( RT ) , amifostine had been shown to reduce xerostomia without changing tumor control . METHODS AND MATERIAL S Adults with head- and -neck cancer who underwent once-daily RT for 5 - 7 weeks ( total dose , 50 - 70 Gy ) received either  open-label amifostine ( 200 mg/m2 i.v . ) 15 - 30 min before each fraction of radiation ( n = 150 ) or RT alone ( control ; n = 153 ) . RESULTS Amifostine administration was associated with a reduced incidence of Grade > or = 2 xerostomia over 2 years of follow-up ( p = 0.002 ) , an increase in the proportion of patients with meaningful ( > 0.1 g ) unstimulated saliva production at 24 months ( p = 0.011 ) , and reduced mouth dryness scores on a patient benefit question naire at 24 months ( p < 0.001 ) . Locoregional control rate , progression-free survival , and overall survival were not significantly different between the amifostine group and the control group . CONCLUSIONS Amifostine administration during head- and -neck RT reduces the severity and duration of xerostomia 2 years after treatment and does not seem to compromise locoregional control rates , progression-free survival , or overall survival The aim of this investigation was to describe and to compare the effectiveness of a CMC- and a mucin-containing saliva substitute .  22 post-radiation patients , 17 Sjögren 's Syndrome patients and 3 patients with xerostomia of unknown origin used a CMC- and a mucin-containing saliva substitute , each for 1 week in an arbitrary sequence . Neither the patient , the assistant , nor the physician were aware of the substitute being used . Each patient had to complete a question naire at 3 different intervals during the trial . One of the conclusions of this study is that mucin-containing substitutes are preferred by patients when compared to CMC-containing substitutes Radiotherapy is used in the setting of curative treatment for head and neck cancer . Xerostomia and related problems occur when major salivary gl and s are included in the irradiation fields . This reduces quality of life ( QOL ) .  Hyperbaric oxygen therapy ( HBOT ) is a well accepted treatment or prevention modality for osteoradionecrosis of the jawbones and soft-tissue necrosis . It is unknown if and to what extent HBOT influences xerostomia and xerostomia-related QOL . To address this , a prospect i ve study was conducted . Twenty-one patients who underwent radiotherapy for an oral or oropharyngeal carcinoma completed a European Organization for Research and Treatment of Cancer  QOL question naire before HBOT , as part of the treatment/prevention of osteoradionecrosis , and 1 and 2 years after HBOT .  Swallowing-related problems significantly decreased in time , and there was a reported subjective increase in saliva quantity and an improvement in sense of taste . The results suggest that HBOT may positively influence these long-term radiotherapy sequelae PURPOSE Pilocarpine hydrochloride administered in either a fixed-dose or in a dose-titration protocol three times a day for 12 weeks was evaluated for its ability to relieve symptoms of postradiation xerostomia and to improve saliva production . The studies were r and omized , double-blind , placebo-controlled , multicenter clinical trials . A total of 369 patients who had received at least 40 Gy of radiation to the head and neck with clinical ly significant xerostomia were enrolled in the two studies . In the dose-titration study , 162 patients were enrolled and they received a thrice daily regimen of 2.5 mg tablets for first 4 weeks , 5.0 mg tablets for the second 4 weeks , and 10.0 mg tablets for last 4 weeks of a 12-week study . Patients in the titration study were allowed to down titrate following at least one dose escalation to alleviate bothersome side effects , if any . In the fixed dose study , 207 patients received either placebo , 5.0 mg , or 10.0 mg tablets t.i.d . for 12 weeks . METHODS AND MATERIAL S Patients were evaluated for symptomatic relief by responding to question naires using visual analog scales and categorical questions ; and , for saliva production by sialometry . Question naires measured relief of intraoral dryness , improvement in overall condition ( global response ) , oral discomfort , difficulty in speaking , chewing and swallowing , denture wearing , and usage of artificial saliva . Evaluations were conducted at baseline , and weeks 4 , 8 , and 12 . RESULTS There were statistically significant improvements in salivary flow in pilocarpine treatment groups vs. placebo . There was a significant improvement in the overall " global " condition of xerostomia associated with the use of pilocarpine in both studies . In the fixed-dose study , there were significant improvements in oral dryness , mouth comfort , ability to speak , and reduction in the use of oral comfort agents . The dose-titration study showed improvements in dryness that approached significance ( p = 0.057 ) and a decreased use of oral comfort agents ( p = 0.045 ) . All pilocarpine dosages ( 2.5 , 5.0 , and 10.0 mg three times a day ) were judged to be safe . Adverse experiences were those expected for a cholinergic agonist , with the most common being mild to moderate sweating . The incidence of these events increased by dose . CONCLUSION It is concluded that in these studies pilocarpine produced clinical ly significant benefits with acceptable side effects and risks for the treatment of symptomatic postradiation xerostomia . The incidence of most adverse events increased with dose . Best results may require continuous treatment for more than 8 weeks with doses greater than 2.5 mg three times a day . A 5.0 mg thrice daily regimen produced the best clinical results when both efficacy and side effects were taken into consideration . There may be some patients who would experience some additional benefit by increasing the dose to 10 mg thrice daily PURPOSE To compare directly the effect of intensity-modulated radiotherapy ( IMRT ) vs. conventional radiotherapy ( CRT ) on salivary flow and quality of life ( QoL ) in patients with early-stage nasopharyngeal carcinoma ( NPC ) . METHODS AND MATERIAL S Fifty-one patients with T2 , N0/N1 , M0 NPC took part in a r and omized controlled clinical study and received IMRT or CRT .  Stimulated whole ( SWS ) and parotid ( SPS ) saliva flow were measured and Medical Outcomes Short Form 36 ( SF-36 ) , European Organization for Research and Treatment of Cancer ( EORTC ) core quetionnaire , and EORTC head- and -neck module ( QLQ-H&N35 ) were completed at baseline and 2 , 6 , and 12 months after radiotherapy . RESULTS Forty-six patients ( 88 % ) were in disease remission 12 months after radiotherapy . At 12 months postradiotherapy , 12 ( 50.0 % ) and 20 patients ( 83.3 % ) in the IMRT group had recovered at least 25 % of preradiotherapy SWS and SPS flow respectively , compared with 1 ( 4.8 % ) and 2 patients ( 9.5 % ) , respectively , in the CRT group . Global health scores showed continuous improvement in QoL after both treatments ( p < 0.001 ) . However , after 12 months subscale scores for role-physical , bodily pain , and physical function were significantly higher in the IMRT group , indicating a better condition ( p < 0.05 ) . Dry mouth and sticky saliva were problems in both groups 2 months after treatment . In the IMRT group , there was consistent improvement over time with xerostomia-related symptoms significantly less common than in the CRT group at 12 months postradiotherapy . CONCLUSIONS IMRT was significantly better than CRT in terms of parotid sparing and improved QoL for early-stage disease . The findings support the case for assessment of health-related QoL in relation to head- and -neck cancer using a site-specific approach AIMS To review the Batra Hospital and Medical Research Centre experience of using compensator-based intensity-modulated radiotherapy ( IMRT ) to treat head and neck cancer . MATERIAL S AND METHODS Between October 2003 and August 2004 , 18 patients underwent IMRT for head and neck cancer at our institution .  IMRT was delivered using partial transmission high-resolution compensator blocks . RESULTS With a median follow-up of 13.3 months , two patients had residual disease and two failed in the gross tumour volume ( GTV ) . The complete response rate after surgical salvage was 94.5 % . Both the locoregional relapse-free and disease-free survival rates were 81.8 % . The target coverage in terms of average maximum , mean and minimum dose ( in Gy ) delivered was 78.6 , 73.5 and 58.4 to the GTV-planning target volume , 82.3 , 70.9 and 47.3 to clinical target volume 1 ( CTV1 ) and 82.9 , 66.2 and 29.6 to CTV2 . The dose constraint of 30 Gy to less than 50 % of the contralateral parotid volume was achieved in 12 ( 66.7 % ) patients . If the dose constraint was revised to 35 Gy , at least 50 % of the parotid volume was spared in 17 ( 94.5 % ) patients . On average , 75 % of the contralateral parotid volume received a dose less than 35 Gy in 13 ( 72.3 % ) patients with grade I xerostomia , whereas this was 49.3 % in five ( 27.7 % ) patients with grade II xerostomia , and the difference was statistically significant ( P = 0.001 ) . CONCLUSIONS In our initial experience , compensator-based IMRT is feasible with regard to target coverage and parotid volume sparing . The parotid volume dose has significant clinical implication s on the grade of xerostomia . Our results invoke rethinking into the issues of the parotid volume dose constraint in our sub population The effect of a new saliva substitute , Salinum , was tested in 37 patients with severe symptoms of reduced salivation .  The majority of the patients had suffered from hyposalivation and dry mouth for more than 8 years . The saliva substitute consisted of a water soluble extract of linseed . The physical properties of this extract are similar to those of the glycoproteins of the salivary secretions . The patients used the saliva substitute for a seven days period . Prior to the use of the extract the patients reported that the most severe symptoms of decreased salivation were a feeling of dryness in the mouth and burning sensations in the tongue , pharynx and oesophagus , The majority of the patients reported that the use of Salinum reduced the symptoms of hyposalivation . Great variation in effect occurred from patient to patient . Generally the patients with the most severe symptoms experienced the greatest relief of the symptoms when they used Salinum . Although of short duration the results of this pilot study indicate that an extract of linseeds may compensate for some aspects of the consequences of reduced salivation . Further studies are needed to eluci date the feasibility of the extract as saliva replacement We studied the effects of pilocarpine hydrochloride , a para-sympathomimetic agent , on major salivary gl and output and subjective responses in 31 patients with salivary hypofunction .  Pilocarpine hydrochloride ( 5-mg capsules , three times daily ) was given for 5 months and a placebo was r and omly assigned for 1 month in a double-blind fashion . Objective measurements of major salivary gl and output , subjective impressions of oral moisture , treatment-related side effects , and a number of phys 
    Output:
    
Conclusions There is evidence that salivary gl and hypofunction and xerostomia induced by cancer therapies can be prevented or symptoms be minimized to some degree , depending on the type of cancer treatment .