Double-blind randomized phase III study comparing a mixture of natural agents versus placebo in the prevention of acute mucositis during chemoradiotherapy for head and neck cancer

Marucci, Laura; Farneti, Alessia; Ridolfi, Paolo Di; Pinnarò, Paola; Pellini, Raul; Giannarelli, Diana; Vici, Patrizia; Conte, M; Landoni, V.; Sanguineti, Giuseppe

doi:10.1002/hed.24832

Cited by 38 publications

(27 citation statements)

References 35 publications

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“…As this study reports about a clinical setting that was not reported previously, this is considered to be initial information that needs confirmation in the future. Propolis was also studied as part of a mixture of 4 natural agents: propolis, Aloe vera, calendula, and chamomile [89]. In this RCT in H&N cancer patients receiving RT, the mixture was reported to be superior to placebo in preventing OM.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of natural and miscellaneous agents, for the management of oral mucositis in cancer patients and clinical practice guidelines — part 2: honey, herbal compounds, saliva stimulants, probiotics, and miscellaneous agents

Yarom

Hovan²,

Bossi

et al. 2020

Support Care Cancer

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Objective To update the clinical practice guidelines for the management of oral mucositis (OM) that were developed by the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). This part focuses on honey, herbal compounds, saliva stimulants, probiotics, and miscellaneous agents. Methods A systematic review was conducted by the Mucositis Study Group of MASCC/ISOO. The body of evidence for each intervention, in each clinical setting, was assigned an evidence level. The findings were added to the database used to develop the 2014 MASCC/ISOO clinical practice guidelines. Based on the evidence level, one of the following guidelines were determined: Recommendation, Suggestion, No Guideline Possible. Results A total of 78 papers were identified within the scope of this section, of which 49 were included in this review and merged with nine publications that were reported in the previous guidelines update. A new Suggestion was made for honey (combined topical and systemic delivery) for the prevention of OM in head and neck cancer patients receiving radiotherapy with or without chemotherapy. A new Suggestion clarified that chewing gum is not effective for the prevention of OM in pediatric patients with hematological or solid cancer treated with chemotherapy. No guideline was possible for other interventions. Conclusions Numerous natural products and herbal remedies were studied for the management of OM. Of the agents reviewed in this systematic review, a guideline in favor was made for honey (combined topical and systemic), while a guideline against was made for chewing gum. Additional research is warranted to clarify the potential of other interventions.

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Section: Discussionmentioning

confidence: 99%

Systematic review of natural and miscellaneous agents, for the management of oral mucositis in cancer patients and clinical practice guidelines — part 2: honey, herbal compounds, saliva stimulants, probiotics, and miscellaneous agents

Yarom

Hovan²,

Bossi

et al. 2020

Support Care Cancer

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“…Thus, it seems important that the relevant substances and production methods of bee products in clinical trials are clearly specified. Furthermore, it is important to note that some trials used diluted bee products or combinations of bee products with other substances which might result in negative results [62]. Adverse interactions are possible.…”

Section: Discussionmentioning

confidence: 99%

Using Bee Products for the Prevention and Treatment of Oral Mucositis Induced by Cancer Treatment

Münstedt

Männle

2019

Molecules

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Oral mucositis is one of the most frequent complications after chemotherapy or radiotherapy or a combination of both. There is no standard therapy for its prevention or treatment. Considering that some bee products have been found to be of value in this situation, we decided to analyze the scientific literature on the subject. Scientific publications on bee products were identified by a literature search on Pubmed, Scopus and Google Scholar. There is a lot of evidence regarding the use of honey for oral mucositis due to chemotherapy or radiotherapy or a combination of both. Unfortunately, the quality of several meta-analyses on the topic is very low. There is some evidence on propolis, a little on royal jelly and none whatsoever on pollen and other bee products like apilarnil or bee venom. Bee products such as honey, propolis and royal jelly may be well suited to be integrated into a general concept for the prevention and treatment of oral mucositis which should also include other established concepts like oral care, oral cryotherapy, topical vitamin E and low-level-laser therapy. Bee products could become an integral part in the treatment of chemotherapy, radiotherapy and radio chemotherapy. High-quality meta-analyses and further studies, especially on the combinations of various strategies, are needed.

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“…In our reviewed studies, propolis and Aloe vera were reported to alleviate radiation-induced mucositis in Wistar rat model and phase II trial respectively [ 108 , 147 ]. However, Marucci et al conducted double-blind randomized phase III study, reporting that some natural products including propolis and Aloe vera had no effect on acute mucositis during chemoradiotherapy for head and neck carcinoma [ 156 ]. Yet, many natural products such as curcumin, ginger, green tea, honey and Hangeshashinto and so forth still show consistent efficacy in both in vivo, in vitro and clinical trial.…”

Section: Limitations Of the Studiesmentioning

confidence: 99%

Plant Extracts as Possible Agents for Sequela of Cancer Therapies and Cachexia

et al. 2020

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Cancer is a leading cause of the death worldwide. Since the National Cancer Act in 1971, various cancer treatments were developed including chemotherapy, surgery, radiation therapy and so forth. However, sequela of such cancer therapies and cachexia are problem to the patients. The primary mechanism of cancer sequela and cachexia is closely related to reactive oxygen species (ROS) and inflammation. As antioxidant properties of numerous plant extracts have been widely reported, plant-derived drugs may have efficacy on managing the sequela and cachexia. In this study, recent seventy-four studies regarding plant extracts showing ability to manage the sequela and cachexia were reviewed. Some plant-derived antioxidants inhibited cancer proliferation and inflammation after surgery and others prevented chemotherapy-induced normal cell apoptosis. Also, there are plant extracts that suppressed radiation-induced oxidative stress and cell damage by elevation of glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and regulation of B-cell lymphoma 2 (BcL-2) and Bcl-2-associated X protein (Bax). Cachexia was also alleviated by inhibition of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6) and monocyte chemoattractant protein-1 (MCP-1) by plant extracts. This review focuses on the potential of plant extracts as great therapeutic agents by controlling oxidative stress and inflammation.

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Double-blind randomized phase III study comparing a mixture of natural agents versus placebo in the prevention of acute mucositis during chemoradiotherapy for head and neck cancer

Cited by 38 publications

References 35 publications

Systematic review of natural and miscellaneous agents, for the management of oral mucositis in cancer patients and clinical practice guidelines — part 2: honey, herbal compounds, saliva stimulants, probiotics, and miscellaneous agents

Systematic review of natural and miscellaneous agents, for the management of oral mucositis in cancer patients and clinical practice guidelines — part 2: honey, herbal compounds, saliva stimulants, probiotics, and miscellaneous agents

Using Bee Products for the Prevention and Treatment of Oral Mucositis Induced by Cancer Treatment

Plant Extracts as Possible Agents for Sequela of Cancer Therapies and Cachexia

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