1.
Effects of herbal medicine for xerostomia in head and neck cancer patients: an observational study in a tertiary cancer hospital.
Lim, RJ, Nik Nabil, WN, Chan, SY, Wong, YF, Han, LX, Gong, JY, Ho, KL, Shew, YS, Xu, L
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2019;(9):3491-3498
Abstract
PURPOSE More than 80% head and neck cancer patients endured radiotherapy-induced xerostomia which impacts their quality of life (QoL). This observational study evaluated the effect of herbal treatment on head and neck cancer patients' xerostomia and QoL. METHODS Head and neck cancer patients were recruited from July 2016 till March 2017 at National Cancer Institute, Ministry of Health, Malaysia. All study participants continued their standard oncology surveillance. Treatment group participants additionally received Chinese herbal treatment. The assessments included unstimulated salivary flow rate (USFR), stimulated salivary flow rate (SSFR), and QoL questionnaire. RESULTS Of 42 recruited participants, 28 were in the treatment group and 14 were in the control group. Participants were mainly Chinese (71.4%), stage III cancer (40.5%), and had nasopharynx cancer (76.2%). The commonly used single herbs were Wu Mei, San Qi, and Tian Hua Fen. Sha Shen Mai Dong Tang, Liu Wei Di Huang Wan, and Gan Lu Yin were the frequently prescribed herbal formulas. The baseline characteristics, USFR, SSFR, and QoL between control and treatment groups were comparable (p > 0.05). USFR between control and treatment groups were similar throughout the 6-month study period. SSFR for the treatment group significantly improved from 0.15 ± 0.28 ml/min (baseline) to 0.32 ± 0.22 ml/min (p = 0.04; at the 3rd month) and subsequently achieved 0.46 ± 0.23 ml/min (p = 0.001; at the 6th month). The treatment group had better QoL in terms of speech (p = 0.005), eating (p = 0.02), and head and neck pain (p = 0.04) at the 6th month. CONCLUSION Herbal treatment may improve xerostomia and QoL in post-radiotherapy head and cancer patients.
2.
Effects of a compound vitamin B mixture in combination with GeneTime® on radiation-induced oral mucositis.
Sun, H, Zhu, X, Li, D, Cheng, T
The Journal of international medical research. 2019;(5):2126-2134
Abstract
OBJECTIVE Both compound vitamin B mixtures and GeneTime® have been used in treatment of oral inflammation. This study aimed to assess the therapeutic effects of a compound vitamin B mixture combined with GeneTime® on radiation-induced oral mucositis. METHODS A total of 100 patients with radiation-induced oral mucositis were randomly divided into a control group (vitamin B alone; n = 50 patients) and an observation group (vitamin B plus GeneTime®, n = 50 patients). Clinical outcomes were compared between the two groups for the following 3 weeks. RESULTS The observation group had a significantly greater number of grade 0-I patients and significantly fewer grade II-IV patients than the control group. Among patients in the observation group, a significantly greater number of ulcers healed within 1-2 weeks, compared with those in patients in the control group. Significantly fewer ulcers healed among patients in the observation group at 3 weeks; notably, there were fewer ulcers to heal in the observation group, compared with the control group. CONCLUSIONS Use of a compound vitamin B mixture combined with GeneTime® exerted obvious therapeutic effects on radiation-induced oral mucositis and markedly shortened ulcer healing time. Therefore, this strategy may be useful in clinical applications.
3.
Statins Protect Against Acute RT-related Rectal Toxicity in Patients with Prostate Cancer: An Observational Prospective Study.
Palumbo, I, Matrone, F, Montesi, G, Bellavita, R, Lupattelli, M, Saldi, S, Frattegiani, A, Arena, E, Mariucci, C, Falcinelli, L, et al
Anticancer research. 2017;(3):1453-1457
Abstract
AIM: To analyze risk factors for acute rectal toxicity during hypofractionated intensity-modulated radiotherapy (IMRT) for prostate cancer. PATIENTS AND METHODS A total of 195 patients received 74.25 Gy in 33 fractions to the prostate and, if involved, to the seminal vescicles (SV). When the risk of SV involvement was >15% according to the Roach's formula, they received 62 Gy in 33 fractions. Overall, 107/195 patients (54.87%) received hormonal therapy (luteinizing hormone-releasing hormone analogue, anti-androgen, or both). Common Terminology Criteria for Adverse Events version 3.0 was used to classify rectal toxicity. RESULTS Acute rectal toxicity occurred in 79 (40.51%) patients (grade 1 in 44). In univariate analysis, use of calcium channel blockers significantly reduced the acute rectal toxicity rate and 3-hydroxy-methylglutaryl CoA reductase inhibitors (statins) significantly reduced the rectal toxicity rate and grade. In multivariate analysis, only statin use was an independent protective factor. CONCLUSION In patients with prostate cancer treated with a moderate hypofractionated IMRT schedule, use of statins lowered the incidence and grade of acute rectal toxicity.
4.
Vitamin D Deficiency Is Associated With the Severity of Radiation-Induced Proctitis in Cancer Patients.
Ghorbanzadeh-Moghaddam, A, Gholamrezaei, A, Hemati, S
International journal of radiation oncology, biology, physics. 2015;(3):613-8
Abstract
PURPOSE Radiation-induced injury to normal tissues is a common complication of radiation therapy in cancer patients. Considering the role of vitamin D in mucosal barrier hemostasis and inflammatory responses, we investigated whether vitamin D deficiency is associated with the severity of radiation-induced acute proctitis in cancer patients. METHODS AND MATERIALS This prospective observational study was conducted in cancer patients referred for pelvic radiation therapy. Serum concentration of 25-hydroxyvitamin D was measured before radiation therapy. Vitamin D deficiency was defined as 25-hydroxyvitamin D concentrations of <35 nmol/L and <40 nmol/L in male and female patients, respectively, based on available normative data. Acute proctitis was assessed after 5 weeks of radiation therapy (total received radiation dose of 50 Gy) and graded from 0 to 4 using Radiation Therapy Oncology Group (RTOG) criteria. RESULTS Ninety-eight patients (57.1% male) with a mean age of 62.8 ± 9.1 years were studied. Vitamin D deficiency was found in 57 patients (58.1%). Symptoms of acute proctitis occurred in 72 patients (73.4%) after radiation therapy. RTOG grade was significantly higher in patients with vitamin D deficiency than in normal cases (median [interquartile range] of 2 [0.5-3] vs 1 [0-2], P=.037). Vitamin D deficiency was associated with RTOG grade of ≥2, independent of possible confounding factors; odds ratio (95% confidence interval) = 3.07 (1.27-7.50), P=.013. CONCLUSIONS Vitamin D deficiency is associated with increased severity of radiation-induced acute proctitis. Investigating the underlying mechanisms of this association and evaluating the effectiveness of vitamin D therapy in preventing radiation-induced acute proctitis is warranted.