Assessment of combined efficacy of Drakshaguduchyadi gargling and Khadiradi Vati lozenges in curative-intent radiotherapy-induced xerostomia in head-and-neck cancer

Background Xerostomia is a common adverse effect of radiotherapy for head-and-neck cancers, leading to significant impairment of oral health and overall quality of life. Evidence-based guidelines for managing radiation-induced xerostomia remain limited, and the majority of available options provide only temporary symptomatic relief. In Ayurveda, this condition is described under mukharoga (oral diseases). Objectives The objective of the study was to evaluate the combined effect of Drakshaguduchyadi Kavala (gargling) and Khadiradi Vati lozenges on symptoms of radiotherapy-induced xerostomia using subjective questionnaires, sialometry, and salivary pH measurements. Materials and methods A total of 20 patients were enrolled with clinically diagnosed radiotherapy-induced xerostomia. Subjective outcomes were assessed using a xerostomia questionnaire and analyzed using the Wilcoxon signed-rank test. Objective outcomes, including unstimulated salivary flow, stimulated salivary flow, and salivary pH, were evaluated using sialometry and analyzed using the paired t -test. Patients received Khadiradi Vati lozenges followed by Drakshaguduchyadi Kavala (gargling) three times daily for 30 days. Results After 30 days of intervention, significant improvement was observed in multiple subjective symptoms, including oral dryness, chewing and swallowing difficulty, choking sensation, sticky saliva, impaired enjoyment of food, and difficulty in speech. Objective parameters—unstimulated and stimulated sialometry values and salivary pH—also exhibited statistically significant improvement. Conclusion Drakshaguduchyadi Kavala (gargling) and Khadiradi Vati lozenges can be considered as a treatment option in radiotherapy-induced xerostomia. Clinical trial registration Identifier CTRI/2019/12/022396.