Chinese Herbal Medicine to Reduce Radiation-Induced Oral Mucositis in Head and Neck Cancer Patients: Evidence From Population-Based Health Claims

Abstract

Background: Subjects with head and neck cancer (HNC) often experience post-treatment side effects, particularly radiation-induced oral mucositis (RIOM). This study aimed to explore the association of Chinese herbal medicine use with the sequent risk of RIOM among them. Methods: This cohort study used a nationwide health insurance database to identify subjects newly diagnosed with HNC, aged 20 to 60 years, who received treatment between 2000 and 2007. Among them, a total of 561 cases received CHM after HNC onset (CHM users); the remaining 2395 cases were non-CHM users. All patients were followed to the end of 2012 to identify any treatment for RIOM as the end point. Cox proportional hazards regression was used to compute the adjusted hazard ratio (aHR) of RIOM by CHM use. Results: During the follow-up period, 183 CHM users and 989 non-CHM users developed RIOM at incidence rates of 40.98 and 57.91 per 1000 person-years, respectively. CHM users had a lower RIOM risk than the non-CHM users (aHR: 0.68; 95% Confidence Interval: 0.58-0.80). The most potent effect was observed in those taking CHM for more than 1 year. Use of Baizhi, Danshen, Shao-Yao-Gan-Cao-Tang, Gan-Lu-Yin, Huangqin, Shu-Jing-Huo-Xue-Tang, and Xin-Yi-Qing-Fei-Tang, was significantly related to a lower risk of RIOM. Conclusion: Findings of this study indicated that adding CHM to conventional clinical care could be helpful in protecting those with HNC against the onset of RIOM. Further clinical and mechanistic studies are warranted.

Network Pharmacology and Molecular Docking Reveal the Mechanism of Corydalis saxicola Bunting Total Alkaloids in Treating Radiation‐Induced Oral Mucositis

“…[9] In recent years, TCM has been popular among patients for its effectiveness in preventing and treating toxic side effects after radiotherapy. [10] From the point of view of TCM, the pathogenesis of RIOM is mostly based on "fire toxicity", [11] which referred to its severe inflammation. Therefore, "clearing heat and detoxifying toxins" is one of the basic principles in the treatment of RIOM.…”

“…Therefore, "clearing heat and detoxifying toxins" is one of the basic principles in the treatment of RIOM. [10] As a herbal medicine to clear heat and detoxifying, Corydalis saxicola Bunting shows potential in relieving RIOM.…”

Efficacy of nonpharmacological interventions for severe radiation‐induced oral mucositis among head and neck cancer patients: A network meta‐analysis of randomised controlled trials

“…Notably, oral mucositis becomes severe as these symptoms advance and subsequently leads to numerous concerns, such as intolerable pain, severely reduced nutritional intake, escalating infection risk, treatment interruption and prolonged hospitalisation, all of which can ultimately impair quality of life in patients with HNC (An et al., 2021; H.‐H. Li et al., 2021). Accordingly, the identification of effective interventions to manage this debilitating complication is essential.…”

“…Currently, no definitive conclusion has been reached regarding the optimal intervention for the treatment of radiation‐induced oral mucositis (H.‐H. Li et al., 2021). Although several reviews have summarised the nonpharmaceutical therapies of oral mucositis, they were narrative in nature rather than applying meta‐analysis methods (Ferreira et al., 2022; Yarom et al., 2020).…”

Randomised controlled trial of Jiandu granule in preventing chemoradiotherapy‐induced oral mucositis

“…According to TCM theory, the main pathological characteristics of OM induced by CCRT are heat, stasis and deficiency (Li et al, 2021).…”