Acupuncture for xerostomia: clinical update.

BACKGROUND In the authors' clinic, patients with xerostomia after radiation therapy for malignancy have been offered acupuncture as potential palliation of their symptoms since November 1999. Preliminary data revealed that many patients achieve relief, even for symptoms refractory to pilocarpine therapy. METHODS Acupuncture technique has been refined since the authors' previous publication. Originally described as a two-step process, a single treatment with eight needles is now used. Three points are treated in each ear, and one in the radial aspect of each index finger. Patients are also provided a sugar-free lozenge in the mouth to further stimulate salivation. Response is measured by the xerostomia inventory (XI). RESULTS Fifty patients have undergone 318 treatments (median, 5; range, 2-15 treatments). Median follow-up since the first treatment is 224 days (range, 9-455 days). Median palliation as described by the XI was 9 points (range, 0-25 points). Response (defined as improvement of 10% or better over baseline XI values) occurred in 35 patients (70%). Twenty-four patients (48%) have received benefit of 10 points or greater on the XI. Duration of effect for 13 patients (26%) has exceeded 3 months. CONCLUSIONS Acupuncture palliates xerostomia for many patients. A regimen of three to four weekly treatments followed by monthly sessions is now recommended, although some patients achieve lasting response without further therapy.