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