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Prophylactic management of radiation-induced mucositis using herbal mouthwash in patients with head and neck cancer: an assessor-blinded randomized controlled trial

  • Sirikorn Kongwattanakul , Nutjaree Petchann , Petcharat Petroch , Saengrawee Thanthong , Sunanta Tungfung , Sasikarn Chamchod ORCID logo , Supaporn Pitiporn and Danupon Nantajit ORCID logo EMAIL logo
Published/Copyright: February 28, 2022
Journal of Complementary and Integrative Medicine
From the journal Journal of Complementary and Integrative Medicine Volume 19 Issue 3

Abstract

Objectives

Radiation-induced mucositis (RIOM) is one of the most common side effects from head and neck radiotherapy. Several reagents have been introduced to manage the symptom; however, there is still a limited number of effective reagents. Herbal mouthwashes with payayor (Clinacanthus nutans Lindau) and fingerroot (Boesenbergia rotunda) were tested their efficacies in preventing and reducing severity of RIOM in comparison with normal saline with sodium bicarbonate.

Methods

One hundred twenty patients with head and neck cancer undergoing radiotherapy participated in the study and were randomly assigned into three treatment groups using block randomization method. The participants were assigned one of the three mouthwashes for use throughout their radiotherapy course and were assessed for their mucositis scores from week one to six into their radiotherapy course as well as at one-month follow-up. Body mass index was also measured for comparison of nutritional status.

Results

The two mouthwashes were similarly effective in prophylaxis of RIOM in term of severity. The averaged mucositis scores were less than two for all groups. For the onset of RIOM, both herbal mouthwashes could slightly delay the symptom but not statistically significant. Patients’ body mass index across the three treatment groups was also comparable. The patients were largely satisfied with all the mouthwashes with no clear preference on any of them.

Conclusions

Prophylactic treatment of RIOM using herbal mouthwashes could substitute the current standard of normal saline with bicarbonate. A different formulation of the two herbs could potentially improve the prophylactic outcome.

Trial Registration No

NCT03359187.

Keywords: herbal mouthwash; mucositis; natural product; prophylaxis; radiation toxicity
Corresponding author: Danupon Nantajit, Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand; and Centre for Host Microbiome Interactions, Faculty of Dentistry and Craniofacial Sciences, King’s College London, London, UK, E-mail:

Funding source: Chulabhorn Royal Academy

Award Identifier / Grant number: R2R 59/001

Acknowledgments

The authors would like to thank Dr. Kamonwan Soonklang and Mr. Thitiphong Suntharayuth, Chulabhorn Royal Academy, for their assistance in conducting statistical analysis.

  1. Research funding: Chulabhorn Royal Academy (R2R 59/001) and Chaopraya Abhaiphubet Hospital Foundation for the tested products.

  2. Author contributions: SK, STh, SP and DN conceptualized the study. SK, STh, STu, SC, SP and DN designed the experiments. SK, STh, SP and DN contributed to acquisition of funding and supports. SK, NP, PP, STh, STu and SC conducted the study and collected the data. SK, NP and DN participated in data analysis. SK, NP, PP and DN participated in preparation of the tables and figures. STu, SC, SP and DN involved in the interpretation of the data. SK and DN wrote the manuscript. All authors reviewed the manuscript and contributed to the scientific discussion of the work.

  3. Competing interests: Supaporn Pitiporn is an executive of Chaopraya Abhaiphubejhr Hospital Foundation which supported the study. The other authors have no declarations of interest.

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Received: 2021-10-06
Revised: 2022-01-02
Accepted: 2022-02-10
Published Online: 2022-02-28

© 2022 Walter de Gruyter GmbH, Berlin/Boston

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  3. Evidence implementation among complementary medicine practitioners: a meta-summary
  4. Phytochemical: a treatment option for heavy metal induced neurotoxicity
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  23. Probiotic administration enhanced antitrypanosomal effects of diminazene aceturate in dogs experimentally infected with Trypanosoma brucei brucei
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  25. GC-MS analysis of curculigo orchiodes and medicinal herbs with cytotoxic, hepatoprotective attributes of ethanolic extract from Indian origin
  26. Biochemical and histopathological evaluation of liver, kidney, and pancreas in normal Sprague Dawley rats administered aqueous extract of beetroot (Beta vulgaris)
  27. The effectiveness of emotional freedom techniques (EFT) on depression of postmenopausal women: a randomized controlled trial
  28. The formulation and efficacy of topical Dorema ammoniacum in treating Melasma: a randomized double-blind, placebo-controlled trial
  29. Impact of inhalation aromatherapy with Damask Rose (Rosa damascena) on stress, anxiety and hemodynamic parameters of patients undergoing coronary angiography: a single blind randomized clinical trial
  30. Hydro-alcoholic extract of Morus nigra reduces fasting blood glucose and HbA1c% in diabetic patients, probably via competitive and allosteric interaction with alpha-glucosidase enzyme; a clinical trial and in silico analysis
  31. Prophylactic management of radiation-induced mucositis using herbal mouthwash in patients with head and neck cancer: an assessor-blinded randomized controlled trial
  32. Implementation science in New Zealand naturopathic practice: a cross-sectional study
  33. Issues of mindfulness implementation for oncology caregivers
  34. Immediate effect of cold mud pack therapy on autonomic variables in primary hypertensive individuals: a randomized trial
  35. Effect of a Persian metabolic diet on the functional dyspepsia symptoms in patients with postprandial distress syndrome: a randomized, double-blind clinical trial
https://doi.org/10.1515/jcim-2021-0457
Keywords for this article
herbal mouthwash; mucositis; natural product; prophylaxis; radiation toxicity

Articles in the same Issue

  1. Frontmatter
  2. Reviews
  3. Evidence implementation among complementary medicine practitioners: a meta-summary
  4. Phytochemical: a treatment option for heavy metal induced neurotoxicity
  5. The effects of curcumin-containing supplementations on inflammatory markers and lipid profiles in patients with chronic kidney diseases: a systematic review and meta-analysis of randomized controlled trials
  6. A systematic review on traditional medicinal Animal’s parts and products used for the treatment of respiratory tract disorders in Ethiopia
  7. Review on nutraceuticals: phase transition from preventive to protective care
  8. A study of effect of Centella asiatica on oxidative markers in the hippocampus of offsprings born to alcohol-fed pregnant rats and the correlation with their cognitive functions
  9. Anxiogenic and anxiolytic effects of memantine injected into the ventral hippocampus in male stressed mice
  10. Research Articles
  11. Comparison of antithyroid effects and hepatic complications of methimazole with catechin and its nanoencapsulation form in adult male rats
  12. Almond oil restores blood parameters, liver function, blood and liver antioxidants and DNA, and liver histology more efficiently than olive oil in favism
  13. Highly efficient microencapsulation of phytonutrients by fractioned cellulose using biopolymer complexation technology
  14. Ocimum basilicum alleviates blood glucose, lipid profile and iNOS in diabetes gestational rat model
  15. Blood pressure and blood sugar-lowering effects of purified gambir on diabetic hypertensive Wistar Kyoto rats
  16. Assessment of anti-inflammatory and antioxidant activity of quercetin–rutin blend (SophorOx™) – an invitro cell based assay
  17. Subchronic toxicological evaluation of EnXtra™ (standardised extract of Alpinia galanga rhizome) in rats
  18. Ficus glumosa Del. reduces phenylhydrazine-induced hemolytic anaemia and hepatic damage in Wistar rats
  19. Screening of anti-cancerous potential of classical Raudra rasa and modified Raudra rasa modified with hiraka bhasma (nanodiamond) through FTIR & LC-MS analysis
  20. Aqueous extract of Pedalium murex D. Royen ex L. leafy stem protects against lead induced testicular toxicity in Wistar rats
  21. Intrahippocampal co-administration of nicotine and O-acetyl-L-carnitine prevents the H-89-induced spatial learning deficits in Morris water maze
  22. Developmental effects of early-life stress on dopamine D2 receptor and proteins involved in noncanonical D2 dopamine receptor signaling pathway in the prefrontal cortex of male rats
  23. Probiotic administration enhanced antitrypanosomal effects of diminazene aceturate in dogs experimentally infected with Trypanosoma brucei brucei
  24. Acacia arabica (Lam.) Willd. On osteoblastogenesis, osteoblast proliferation, osteoclastic activity, and bone calcium mineralization
  25. GC-MS analysis of curculigo orchiodes and medicinal herbs with cytotoxic, hepatoprotective attributes of ethanolic extract from Indian origin
  26. Biochemical and histopathological evaluation of liver, kidney, and pancreas in normal Sprague Dawley rats administered aqueous extract of beetroot (Beta vulgaris)
  27. The effectiveness of emotional freedom techniques (EFT) on depression of postmenopausal women: a randomized controlled trial
  28. The formulation and efficacy of topical Dorema ammoniacum in treating Melasma: a randomized double-blind, placebo-controlled trial
  29. Impact of inhalation aromatherapy with Damask Rose (Rosa damascena) on stress, anxiety and hemodynamic parameters of patients undergoing coronary angiography: a single blind randomized clinical trial
  30. Hydro-alcoholic extract of Morus nigra reduces fasting blood glucose and HbA1c% in diabetic patients, probably via competitive and allosteric interaction with alpha-glucosidase enzyme; a clinical trial and in silico analysis
  31. Prophylactic management of radiation-induced mucositis using herbal mouthwash in patients with head and neck cancer: an assessor-blinded randomized controlled trial
  32. Implementation science in New Zealand naturopathic practice: a cross-sectional study
  33. Issues of mindfulness implementation for oncology caregivers
  34. Immediate effect of cold mud pack therapy on autonomic variables in primary hypertensive individuals: a randomized trial
  35. Effect of a Persian metabolic diet on the functional dyspepsia symptoms in patients with postprandial distress syndrome: a randomized, double-blind clinical trial
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