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Heydarirad G, Mirzaei HR, Gharehgozlou R, Ghorbanpoor S, Buentzel J, Rampp T, Pasalar M. Effect of Honey-Lime Spray as Add-On Therapy on Chemotherapy-Induced Xerostomia in Breast Cancer Patients: A Pilot Randomized Double-Blinded Controlled Trial. Complement Med Res 2024; 31:133-139. [PMID: 38266506 DOI: 10.1159/000536226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 01/10/2024] [Indexed: 01/26/2024]
Abstract
INTRODUCTION Xerostomia (dry mouth) is a common side effect among patients with cancer undergoing chemotherapy. There is no standard treatment for this symptom yet, although Persian medicine textbooks suggested some products to relieve xerostomia. We aimed to assess the efficacy of honey-lime spray in treating chemotherapy-induced xerostomia in breast cancer patients through a controlled study. METHODS In this pilot, randomized, double-blinded clinical trial conducted in Shohadaye Tajrish Hospital, Iran, the intervention group received honey-lime spray and nystatin, while the control group used distilled water plus nystatin for 2 weeks. The six-item dry mouth form and visual analog score (VAS) were used to evaluate xerostomia extent and pain, respectively. RESULTS The standardized value of the difference between the mean scores before and after the study was -10.21 (p < 0.001), and the effect size was estimated at 55%. Also, VAS showed a significant decrease in pain for the intervention group compared with the control group (p < 0.001). There were no serious side effects. CONCLUSION Honey-lime spray may be a good treatment choice for xerostomia in chemotherapy-induced breast cancer patients, but robust trials with larger samples and prolonged follow-ups are highly recommended. Einleitung Mundtrockenheit (Xerostomie) ist eine häufige Nebenwirkung bei Krebspatienten, die sich einer Chemotherapie unterziehen. Es gibt bisher keine Standardtherapie für dieses Symptom, doch Lehrbücher der persischen Medizin schlagen einige Mittel zur Linderung von Mundtrockenheit vor. Unser Ziel war es, die Wirksamkeit von Honig-Limetten-Spray zur Behandlung von chemotherapiebedingter Mundtrockenheit bei Patientinnen mit Brustkrebs im Rahmen einer kontrollierten Studie zu untersuchen. Methoden In dieser randomisierten, doppelt verblindeten klinischen Pilotstudie, die im Shohadaye Tajrish Hospital im Iran durchgeführt wurde, erhielt die Interventionsgruppe zwei Wochen lang Honig-Limetten-Spray und Nystatin und die Kontrollgruppe destilliertes Wasser plus Nystatin. Ein Mundtrockenheits-Fragebogen mit sechs Items wurde zur Beurteilung der Schwere der Mundtrockenheit verwendet und eine visuelle Analogskala zur Beurteilung der Schmerzen. Ergebnisse Der standardisierte Wert der Differenz zwischen den mittleren Scores vor und nach der Studie betrug −10,21 ( p < 0,01), und die geschätzte Effektstärke betrug 55%. Zudem zeigte die VAS eine signifikante Abnahme der Schmerzen in der Interventionsgruppe im Vergleich zur Kontrollgruppe ( p < 0,01). Es traten keine schwerwiegenden Nebenwirkungen auf. Schlussfolgerung Honig-Limetten-Spray könnte eine gute Wahl für die Behandlung von Mundtrockenheit bei Brustkrebspatientinnen unter Chemotherapie sein, doch hierzu werden belastbare Studien mit größerem Probenumfang und längerer Nachbeobachtung nachdrücklich empfohlen.
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Affiliation(s)
- Ghazaleh Heydarirad
- Traditional Medicine and Materia Medica Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Mirzaei
- Cancer Research Center, Shohada Tajrish Hospital, Department of Radiation Oncology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reyhaneh Gharehgozlou
- Cancer Research Center, Shohada Tajrish Hospital, Department of Radiation Oncology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Judith Buentzel
- Department of Hematology and Medical Oncology, University Medical Center Goettingen, Goettingen, Germany
| | - Thomas Rampp
- Food Production Company, PARK CAKES Bakeries, Oldham, UK
| | - Mehdi Pasalar
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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McGrath C, Clarkson J, Glenny AM, Walsh LJ, Hua F. Effectiveness of Mouthwashes in Managing Oral Diseases and Conditions: Do They Have a Role? Int Dent J 2023; 73 Suppl 2:S69-S73. [PMID: 37867064 PMCID: PMC10690548 DOI: 10.1016/j.identj.2023.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 08/21/2023] [Indexed: 10/24/2023] Open
Abstract
Antimicrobial mouthwashes are considered to reduce dental plaque biofilm and thus the potential to prevent plaque-induced oral diseases, particularly periodontal diseases. The effectiveness of mouthwashes relates to this antiplaque role, as well as, their tooth-whitening potential and ability to mask/mange malodour (halitosis). There is also a growing interest in the use of mouthwashes as an adjunctive measure in post surgical and post-dental care, while the COVID-19 pandemic has given a new lease of life to mouthwashes as an oral antispetic that may be useful in reducing the oral viral load. The mode of action of mouthwashes varies, depending on their active ingredients, concentrations, and mode and frequency of use, as does their potential effectiveness. This article aims to provide a narrative overview of the evidence of the effectiveness of the most widely used mouthwashes in managing oral diseases, oral conditions, and adjunctive care roles.
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Affiliation(s)
- Colman McGrath
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
| | | | - Ann-Marie Glenny
- Division of Dentistry, School of Medical Sciences, University of Manchester, UK
| | | | - Fang Hua
- School & Hospital of Stomatology, Wuhan University, China
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Anggraeni DT, Hayati AT, Nur'aeni A. The effect of oral care using honey as an additional topical agent on oral health status of intubated patients in the intensive care unit. ENFERMERIA INTENSIVA 2022; 33:225-232. [PMID: 36494157 DOI: 10.1016/j.enfie.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 12/26/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Patients using endotracheal tubes are at high risk of oral health status dysfunction due to impaired natural airway defence, oral flora composition changes and protective substances of the teeth, medication causing xerostomia. Oral care has not been enough to manage oral mucosal dryness, so an additional topical agent is needed to protect oral mucosa to maintain oral health. Honey is one of the recommended topical agents. OBJECTIVE This study aims to identify the effect of oral care with honey as topical agents on the oral health status of patients using endotracheal tube in the Intensive Care Unit. METHODS This was an experimental study with a randomized pretest and posttest design. The sample was adult intubated patients, consisting of 36 patients. The data were analysed using the parametric test, and dependent and independent t-test. RESULTS The oral health score in the control group was found to be pre & post mean score11.94 and 13.28 (p=.004) respectively, while in the intervention group 11.89 and 8.33 (p<.001). Mean differences in both groups were 4.95 (p<.001) and the BOAS subscale differences were seen on the lips, gums & mucosa, and tongue (p<.05). CONCLUSION Oral care with honey as a topical agent can improve the oral health status of intubated patients on the lips, gum, mucosa, and tongue subscale. Therefore, honey as an additional topical agent can be a moisturizer to maintain the oral mucosa for intubated patients in the Intensive Care Unit. Furthermore, good mucosal health will help prevent the infection and colonization of microorganisms.
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Affiliation(s)
- D T Anggraeni
- Nursing Department, Faculty of Health Science, Universitas Pembangunan Nasional Veteran Jakarta, Indonesia.
| | - A T Hayati
- Faculty of Dentistry, Padjadjaran University, Indonesia
| | - A Nur'aeni
- Faculty of Nursing, Padjadjaran University, Indonesia
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Anggraeni D, Hayati A, Nur’aeni A. The effect of oral care using honey as an additional topical agent on oral health status of intubated patients in the intensive care unit. ENFERMERIA INTENSIVA 2022. [DOI: 10.1016/j.enfi.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chavan S, Bhuvad S, Kumbhlakar B, Auti J, Walunj T, Pathak S, Tanpure R, Gujar S, Shinde J, Kulkarni A, Gupta V, Deshmukh V, Sardeshmukh S. Antimicrobial and antioxidant potential of a standardized Ayurvedic formulation explains its clinical efficacy as gargles in post-radiotherapy oral cancer patients. J Herb Med 2021. [DOI: 10.1016/j.hermed.2021.100510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Amorim LS, Marques Goes PE, Figueiredo RDA, Souza JADCR, Tavares JF, Castellano LRC, Castro RDD, Farias D, de Aquino SG. In vitro antibacterial and anti-inflammatory effects of Anacardium occidentale L. extracts and their toxicity on PBMCs and zebrafish embryos. Drug Chem Toxicol 2021; 45:2653-2663. [PMID: 34595971 DOI: 10.1080/01480545.2021.1981365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study evaluated the in vitro antimicrobial and immunomodulatory action of crude extracts from Anacardium occidentale L. (cashew tree) leaves and bark, and to determine their toxicity to peripheral-blood mononuclear cells (PBMCs) and to zebrafish embryos and larvae. Chemical analysis of extracts was performed by proton nuclear magnetic resonance (1H-NMR). The antibacterial activity was evaluated against selected bacteria strains by determining the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Cytotoxicity of the extracts was assessed using resazurin method, while the effect on production of ROS by PMN leukocytes was measured by luminol. Embryotoxicity to zebrafish was assessed using the fish embryo acute toxicity test (FET) and quantification of toxicity marker enzymes (AChE, LDH, and GST). 1H-NMR results showed anacardic acid as the main component of the extracts. All bacterial species tested were sensitive to the extracts, with MICs ranging from 312.5 to 10,000 μg/mL. Streptococcus mutans and Escherichia coli were the most susceptible species. The extracts promoted cell viability above 75% at concentrations from 1.25 to 80 μg/mL. Both extracts reduced zymosan-induced ROS (p < 0.05) at concentrations of 1, 8, and 80 μg/mL compared to the control. In vivo, there were embryotoxic effects in zebrafish embryos exposed to both extracts through the presence of lethal and sublethal endpoints. The samples also acted by inhibiting the activities of biomarker enzymes. The A. occidentale L. bark and leaf extracts showed antimicrobial potential and modulated ROS production in vitro, but these also showed embryotoxic effects to zebrafish.
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Affiliation(s)
- Luana Souza Amorim
- Graduate Program in Dentistry, Center of Health Sciences, Federal University of Paraíba - UFPB, João Pessoa, Brazil
| | - Pedro Everton Marques Goes
- Graduate Program in Dentistry, Center of Health Sciences, Federal University of Paraíba - UFPB, João Pessoa, Brazil
| | | | | | - Josean Fechine Tavares
- Department of Pharmaceutical Sciences, Center of Health Sciences, Federal University of Paraíba - UFPB, João Pessoa, Brazil
| | | | - Ricardo Dias de Castro
- Graduate Program in Dentistry, Center of Health Sciences, Federal University of Paraíba - UFPB, João Pessoa, Brazil
| | - Davi Farias
- Department of Molecular Biology, Center of Exact and Natural Sciences (CCEN), Federal University of Paraíba - UFPB, João Pessoa, Brazil
| | - Sabrina Garcia de Aquino
- Graduate Program in Dentistry, Center of Health Sciences, Federal University of Paraíba - UFPB, João Pessoa, Brazil
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Ptasiewicz M, Maksymiuk P, Chałas R. Changes of Dentition State in Leukemic Patients during Chemotherapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8193. [PMID: 34360486 PMCID: PMC8346006 DOI: 10.3390/ijerph18158193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/28/2021] [Accepted: 07/30/2021] [Indexed: 12/02/2022]
Abstract
A number of systemic diseases including hematological disorders have manifestations in the oral cavity region. These manifestations may often represent early signs of the underlying hematopoietic disease and occur frequently in leukemia. Despite the fact that leukemia has long been known to be associated with oral health deterioration, the available literature on this topic consists mostly of case reports, without data to conclude these. The aim of the study was to assess dentition state in leukemic patients during one cycle of chemotherapy and its correlation with blood parameters. The study included 102 adults treated because of leukemia at the Clinic of Haemato-Oncology and Bone Marrow Transplantation at the university hospital in Lublin, Poland. The sample group consisted of 51 women and 51 men aged 22 to 72 (54.07 ± 10.33) with following diagnoses: Acute myelogenous leukemia (AML)-55 patients (53.92%), Chronic lymphocytic leukemia (CLL)-17 patients (16.67%), Acute lymphoblastic leukemia (ALL)-16 patients (15.69%), Chronic myelogenous leukemia (CML)-10 patients (9.80%), Acute promyelocytic leukemia (APL) -3 patients (2.94%), Chronic hairy cell leukemia (HCL)-1 patient (0.98%). DMFT index was used to assess dentition state. After the cycle of chemotherapy, their dentition state changed in terms of decayed, missing and filled teeth and correlated with hematological parameters. Adult patients with leukemia have high dental treatment needs, and high number of missing teeth; thus, a comprehensive and fast dental treatment is necessary to avoid systemic complications and ensure better quality of life.
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MESH Headings
- Adult
- Dentition
- Female
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/epidemiology
- Male
- Quality of Life
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Affiliation(s)
| | - Paweł Maksymiuk
- Department of Oral Medicine, Medical University of Lublin, ul. Chodźki 6, 20-093 Lublin, Poland; (M.P.); (R.C.)
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Berner T, Nakahara K, Kobayashi E, Tanaka A, Taniguchi Y, Iizuka T, Sawada K. Investigating the effect of antiseptic solution on the release of interleukin-6 and transforming growth factor beta 1 from human gingival fibroblasts using wound healing assays. J Oral Sci 2020; 62:293-297. [PMID: 32581176 DOI: 10.2334/josnusd.19-0151] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This in vitro study evaluated the effect of different antiseptics and different concentrations thereof in a model of wound healing using human gingival fibroblasts. The fibroblasts were rinsed with four different antiseptic solutions: sodium hypochlorite (HYP), hydrogen peroxide (H2O2), chlorhexidine digluconate (CHX), and benzalkonium chloride (BC). The effect on the release of interleukin-6 (IL-6) and transforming growth factor beta 1 (TGF-β1) was investigated using enzyme-linked immunosorbent assays (ELISAs). In addition, the effects of the antiseptics on wound healing at 1, 12, 24, and 48 h were assessed through a wound healing assay. The viability of the fibroblasts rinsed with antiseptics was investigated with respect to the concentrations inhibiting cell growth by 50% (IC50), 25% (IC25), and ≤2% (IC2). A statistically significant increased release of IL-6 was obtained with BC IC25 and IC2 after 12, 24, and 48 h (P < 0.01). For TGF-β1, no significant release was found for CHX IC2 after 24 and 48 h or for IC50 and IC25 after 12 h. There was no significant effect on wound healing capacity for CHX or for BC IC25 and IC2. This study demonstrated that antiseptic rinses of human gingival fibroblasts alter the release of IL-6 and TGF-β1 and impact wound healing capacity, with both BC and CHX conferring neutral effects.
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Affiliation(s)
- Tanja Berner
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata.,Center of Dental Medicine, University of Zurich
| | - Ken Nakahara
- Advanced Research Center, The Nippon Dental University School of Life Dentistry at Niigata
| | - Eizaburo Kobayashi
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata
| | - Akira Tanaka
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata
| | - Yoichi Taniguchi
- Department of Periodontology, Graduate School, Tokyo Medical and Dental University
| | - Tateyuki Iizuka
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern
| | - Kosaku Sawada
- Advanced Research Center, The Nippon Dental University School of Life Dentistry at Niigata
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Alkhouli M, Laflouf M, Alhaddad M. Evaluation of the effectiveness of olive oil to prevent chemotherapy induced oral mucositis: A randomized controlled clinical trial. PEDIATRIC DENTAL JOURNAL 2019. [DOI: 10.1016/j.pdj.2019.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bertolini M, Ranjan A, Thompson A, Diaz PI, Sobue T, Maas K, Dongari-Bagtzoglou A. Candida albicans induces mucosal bacterial dysbiosis that promotes invasive infection. PLoS Pathog 2019; 15:e1007717. [PMID: 31009520 PMCID: PMC6497318 DOI: 10.1371/journal.ppat.1007717] [Citation(s) in RCA: 106] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 05/02/2019] [Accepted: 03/19/2019] [Indexed: 12/12/2022] Open
Abstract
Infectious complications are a common cause of morbidity and mortality in cancer patients undergoing chemotherapy due to increased risk of oral and gastrointestinal candidiasis, candidemia and septicemia. Interactions between C. albicans and endogenous mucosal bacteria are important in understanding the mechanisms of invasive infection. We published a mouse intravenous chemotherapy model that recapitulates oral and intestinal mucositis, and myelosuppression in patients receiving 5-fluorouracil. We used this model to study the influence of C. albicans on the mucosal bacterial microbiome and compared global community changes in the oral and intestinal mucosa of the same mice. We validated 16S rRNA gene sequencing data by qPCR, in situ hybridization and culture approaches. Mice receiving both 5Fu and C. albicans had an endogenous bacterial overgrowth on the oral but not the small intestinal mucosa. C. albicans infection was associated with loss of mucosal bacterial diversity in both sites with indigenous Stenotrophomonas, Alphaproteobacteria and Enterococcus species dominating the small intestinal, and Enterococcus species dominating the oral mucosa. Both immunosuppression and Candida infection contributed to changes in the oral microbiota. Enterococci isolated from mice with oropharyngeal candidiasis were implicated in degrading the epithelial junction protein E-cadherin and increasing the permeability of the oral epithelial barrier in vitro. Importantly, depletion of these organisms with antibiotics in vivo attenuated oral mucosal E-cadherin degradation and C. albicans invasion without affecting fungal burdens, indicating that bacterial community changes represent overt dysbiosis. Our studies demonstrate a complex interaction between C. albicans, the resident mucosal bacterial microbiota and the host environment in pathogenesis. We shed significant new light on the role of C. albicans in shaping resident bacterial communities and driving mucosal dysbiosis.
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Affiliation(s)
- Martinna Bertolini
- Department of Oral Health Sciences, University of Connecticut Health Center, Farmington, Connecticut, United States of America
| | - Amit Ranjan
- Department of Oral Health Sciences, University of Connecticut Health Center, Farmington, Connecticut, United States of America
| | - Angela Thompson
- Department of Oral Health Sciences, University of Connecticut Health Center, Farmington, Connecticut, United States of America
| | - Patricia I. Diaz
- Department of Oral Health Sciences, University of Connecticut Health Center, Farmington, Connecticut, United States of America
| | - Takanori Sobue
- Department of Oral Health Sciences, University of Connecticut Health Center, Farmington, Connecticut, United States of America
| | - Kendra Maas
- Microbial Analysis, Resources, and Services Core, University of Connecticut, Storrs, Connecticut, United States of America
| | - Anna Dongari-Bagtzoglou
- Department of Oral Health Sciences, University of Connecticut Health Center, Farmington, Connecticut, United States of America
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The Effect of Oral Care with Chlorhexidine, Vitamin E and Honey on Mucositis in Pediatric Intensive Care Patients: A Randomized Controlled Trial. J Pediatr Nurs 2019; 45:e95-e101. [PMID: 30745073 DOI: 10.1016/j.pedn.2019.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 01/30/2019] [Accepted: 02/01/2019] [Indexed: 12/27/2022]
Abstract
PURPOSE This study was performed to determine the effect of oral care using chlorhexidine, vitamin E and honey on oral mucositis (OM) management in children treated in a pediatric intensive care unit (PICU). DESIGN AND METHODS The study was a randomized controlled trial with a parallel design. The study sample was composed of 150 children who were treated in the PICU of a university hospital in Turkey. Children enrolled in the study were randomly divided into six groups based on the oral care solutions used (n = 25 in each group). The Demographic Information Form and the World Health Organization Oral Mucositis Index were used for data collection. RESULTS The mucositis indices of the children presenting with and without OM upon admission to the PICU were compared on days 1, 3, 6, 9, 12, 15, 18 and 21 and the study found that the mucositis index values of the children treated with vitamin E were significantly lower than in the other groups (p < 0.05 for each), while those of the children given chlorhexidine were significantly higher than in the other groups (p < 0.05 for each). CONCLUSIONS At the end of the study, vitamin E was determined to be the most effective agent in OM management, followed by honey as the second most effective agent. Chlorhexidine was found to be less effective in OM management compared to the other two agents. Based on this, vitamin E is recommended for use in oral mucositis-preventive and therapeutic oral care practices. PRACTICE IMPLICATIONS The results of the present study conducted with PICU patients will be useful in the administration of oral care. These findings are also important for nurses who have the responsibility of oral mucositis management.
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Santos Filho EXD, Arantes DAC, Oton Leite AF, Batista AC, Mendonça EFD, Marreto RN, Naves LN, Lima EM, Valadares MC. Randomized clinical trial of a mucoadhesive formulation containing curcuminoids (Zingiberaceae) and Bidens pilosa Linn (Asteraceae) extract (FITOPROT) for prevention and treatment of oral mucositis - phase I study. Chem Biol Interact 2018; 291:228-236. [DOI: 10.1016/j.cbi.2018.06.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 06/05/2018] [Accepted: 06/12/2018] [Indexed: 02/08/2023]
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Bockel S, Vallard A, Lévy A, François S, Bourdis M, Le Gallic C, Riccobono D, Annede P, Drouet M, Tao Y, Blanchard P, Deutsch É, Magné N, Chargari C. Pharmacological modulation of radiation-induced oral mucosal complications. Cancer Radiother 2018; 22:429-437. [PMID: 29776830 DOI: 10.1016/j.canrad.2017.11.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 11/09/2017] [Accepted: 11/15/2017] [Indexed: 12/12/2022]
Abstract
Radiation-induced mucositis is a common toxicity, especially in patients with head and neck cancers. Despite recent technological advances in radiation therapy, such as intensity-modulated radiotherapy, radiation-induced mucositis is still causing treatment disruptions, negatively affecting patients' long and short term quality of life, and impacting medical resources use with economic consequences. The objective of this article was to review the latest updates in the management of radiation-induced mucositis, with a focus on pharmaceutical strategies for the prevention or treatment of mucositis. Although numerous studies analysing the prevention and management of oral radiation-induced mucositis have been conducted, there are still few reliable data to guide daily clinical practice. Furthermore, most of the tested drugs have shown no (anti-inflammatory cytokine, growth factors) or limited (palifermin) effect. Therapies for acute oral mucositis are predominantly focused on improving oral hygiene and providing symptoms control. Although low-level laser therapy proved efficient in preventing radiation-induced oral mucositis in patients with head and neck cancer, this intervention requires equipment and trained medical staff, and is therefore insufficiently developed in clinical routine. New effective pharmacological agents able to prevent or reverse radio-induced mucositis are required.
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Affiliation(s)
- S Bockel
- Département de radiothérapie, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - A Vallard
- Département de radiothérapie, institut de cancérologie Lucien-Neuwirth, 108, bis avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France
| | - A Lévy
- Département de radiothérapie, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - S François
- Département effets biologiques des rayonnements, institut de recherche biomédicale des armées, D19, 91220 Brétigny-sur-Orge, France
| | - M Bourdis
- Département interdisciplinaire des soins de support pour le patient en oncologie, institut de cancérologie Lucien-Neuwirth, 108, bis avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France
| | - C Le Gallic
- Département effets biologiques des rayonnements, institut de recherche biomédicale des armées, D19, 91220 Brétigny-sur-Orge, France
| | - D Riccobono
- Département effets biologiques des rayonnements, institut de recherche biomédicale des armées, D19, 91220 Brétigny-sur-Orge, France
| | - P Annede
- Département de radiothérapie, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - M Drouet
- Département effets biologiques des rayonnements, institut de recherche biomédicale des armées, D19, 91220 Brétigny-sur-Orge, France
| | - Y Tao
- Département de radiothérapie, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - P Blanchard
- Département de radiothérapie, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - É Deutsch
- Département de radiothérapie, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif, France; Inserm U1030, 114, rue Édouard-Vaillant, 94805 Villejuif, France; Université Paris-Sud, université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
| | - N Magné
- Département de radiothérapie, institut de cancérologie Lucien-Neuwirth, 108, bis avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France
| | - C Chargari
- Département de radiothérapie, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif, France; Inserm U1030, 114, rue Édouard-Vaillant, 94805 Villejuif, France; Université Paris-Sud, université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France; Institut de recherche biomédicale des armées, D19, 91220 Brétigny-sur-Orge, France; Service de santé des armées, école du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France.
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Roldan CJ, Nouri K, Chai T, Huh B. Methylene Blue for the Treatment of Intractable Pain Associated with Oral Mucositis. Pain Pract 2017; 17:1115-1121. [PMID: 28226414 DOI: 10.1111/papr.12566] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 01/04/2017] [Accepted: 01/10/2017] [Indexed: 12/18/2022]
Abstract
Oral mucositis is a common and often debilitating complication among cancer patients receiving radiation therapy to the head and neck or chemotherapy agents, or undergoing hematopoietic stem cell transplantation. Pain and decreased oral function associated with oral mucositis may persist long after the conclusion of therapy. Although most patients respond to conservative management, a subset of patients develops intractable pain with severe consequences. For some, the use of total parenteral nutrition with insertion of percutaneous endoscopic gastrostomy feeding tubes is the only alternative. Current recommendations to treat mucositis and its related pain include basic oral care, bland oral rinses, topical anesthetics, and systemic analgesics. We believe that chemical neurolysis of the affected areas with methylene blue used as an oral rinse is a noninvasive, efficient, safe, and cost-effective alternative that can provide prolonged analgesia in patients with intractable pain of oral mucositis. The benefits of this therapy are reflected in its improvement of patients' quality of life by enabling oral feeding and controlling pain. We report a series of 5 consecutive patients with intractable oral mucositis-related pain despite conventional treatment with systemic opiates. All 5 patients responded well to the use of 0.05% methylene blue as mouth rinse, demonstrating sustained analgesia over 3 weeks. The treatment was tolerated well, and overall patient satisfaction was very high. We also observed that methylene blue rinse significantly reduced the total opioid requirement, as demonstrated by reductions in the patients' morphine equivalent daily dose scores after its use. Our case series suggests that 0.5% methylene blue oral rinse therapy is an effective and inexpensive modality that can be used safely to palliate intractable oral pain in patients with mucositis associated with cancer treatment. To our knowledge, this is the first report using this therapy to treat pain from oral mucositis.
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Affiliation(s)
- Carlos J Roldan
- Department of Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.,Department of Emergency Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, U.S.A.,Memorial Hermann Hospital-Texas Medical Center, Houston, Texas, U.S.A.,Lyndon B. Johnson General Hospital, Houston, Texas, U.S.A
| | - Kent Nouri
- Department of Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Thomas Chai
- Department of Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Billy Huh
- Department of Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
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Cardona A, Balouch A, Abdul MM, Sedghizadeh PP, Enciso R. Efficacy of chlorhexidine for the prevention and treatment of oral mucositis in cancer patients: a systematic review with meta-analyses. J Oral Pathol Med 2017; 46:680-688. [DOI: 10.1111/jop.12549] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Alvin Cardona
- Master of Science Program in Orofacial Pain and Oral Medicine; Herman Ostrow School of Dentistry; University of Southern California; Los Angeles CA USA
| | - Amir Balouch
- Master of Science Program in Orofacial Pain and Oral Medicine; Herman Ostrow School of Dentistry; University of Southern California; Los Angeles CA USA
| | - Moiz Mohammed Abdul
- Master of Science Program in Orofacial Pain and Oral Medicine; Herman Ostrow School of Dentistry; University of Southern California; Los Angeles CA USA
| | - Parish P. Sedghizadeh
- Division of Periodontology, Diagnostic Sciences & Dental Hygiene; Herman Ostrow School of Dentistry; University of Southern California; Los Angeles CA USA
| | - Reyes Enciso
- Division of Dental Public Health and Pediatric Dentistry; Herman Ostrow School of Dentistry; University of Southern California; Los Angeles CA USA
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Mutluay Yayla E, Izgu N, Ozdemir L, Aslan Erdem S, Kartal M. Sage tea–thyme–peppermint hydrosol oral rinse reduces chemotherapy-induced oral mucositis: A randomized controlled pilot study. Complement Ther Med 2016; 27:58-64. [DOI: 10.1016/j.ctim.2016.05.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 05/04/2016] [Accepted: 05/24/2016] [Indexed: 02/02/2023] Open
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Chaveli-López B, Bagán-Sebastián JV. Treatment of oral mucositis due to chemotherapy. J Clin Exp Dent 2016; 8:e201-9. [PMID: 27034762 PMCID: PMC4808317 DOI: 10.4317/jced.52917] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 01/08/2016] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION The management of oral mucositis is a challenge, due to its complex biological nature. Over the last 10 years, different strategies have been developed for the management of oral mucositis caused by chemotherapy in cancer patients. MATERIAL AND METHODS An exhaustive search was made of the PubMed-Medline, Cochrane Library and Scopus databases, crossing the key words "oral mucositis", "prevention" and "treatment" with the terms "chemotherapy" and "radiotherapy" by means of the boolean operators "AND" and "NOT". A total of 268 articles were obtained, of which 96 met the inclusion criteria. RESULTS Several interventions for the prevention of oral mucositis, such as oral hygiene protocols, amifostine, benzidamine, calcium phosphate, cryotherapy and iseganan, among others, were found to yield only limited benefits. Other studies have reported a decrease in the appearance and severity of mucositis with the use of cytoprotectors (sucralfate, oral glutamine, hyaluronic acid), growth factors, topical polyvinylpyrrolidone, and low power laser irradiation. CONCLUSIONS Very few interventions of confirmed efficacy are available for the management of oral mucositis due to chemotherapy. However, according to the reviewed literature, the use of palifermin, cryotherapy and low power laser offers benefits, reducing the incidence and severity of oral mucositis - though further studies are needed to confirm the results obtained. KEY WORDS Chemotherapy-Induced Oral Mucositis Treatment.
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Affiliation(s)
- Begonya Chaveli-López
- DDS. Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Spain
| | - José V Bagán-Sebastián
- MD, DDS, PhD. Head of the Department of Stomatology and Maxillofacial Surgery. Chairman of Oral Medicine. University of Valencia, Spain
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Manzi NDM, Silveira RCDCP, dos Reis PED. Prophylaxis for mucositis induced by ambulatory chemotherapy: systematic review. J Adv Nurs 2015; 72:735-46. [PMID: 26626711 DOI: 10.1111/jan.12867] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2015] [Indexed: 02/01/2023]
Abstract
AIM The aim of this study was to perform a systematic review of clinical trials covering interventions used as prophylaxis for oral mucositis induced by ambulatory antineoplastic chemotherapy. BACKGROUND Oral mucositis in patients undergoing chemotherapy is a side effect that can impact the quality of treatment and can interfere with eating and therapeutic adherence. DESIGN Quantitative systematic review. DATA SOURCES Relevant databases were searched, from January 2002-July 2013, by using the combination of the keywords mucositis, stomatitis, neoplasms, antineoplastic agents, drug therapy, prevention and control and chemotherapy. REVIEW METHODS Two researchers independently read the titles and abstracts from every cross-reference. The quality of the included studies was analysed by the Jadad Scale and the Cochrane Collaboration Risk of Bias Tool. Data were extracted from the selected studies with a data collection form developed specifically for this purpose. RESULTS Of the 23 controlled clinical trials that were identified in this study, five articles evaluated the use of oral cryotherapy to prevent oral mucositis and three studies analysed the prophylactic use of glutamine. Interventions of protocols for oral care, palifermin, allopurinol and chlorhexidine were evaluated by two articles each. Interventions of zinc sulphate, amifostine, chewing gum, sucralfate, recombination human intestinal trefoil factor, kefir and vitamin E were evaluated by one article each. CONCLUSION There is strong evidence that cryotherapy can prevent oral mucositis arising from ambulatory treatment with 5-flurouracil chemotherapy. Other interventions, although showing positive results in preventing oral mucositis, require further study to confirm their conclusions.
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Kanagalingam J, Feliciano R, Hah JH, Labib H, Le TA, Lin JC. Practical use of povidone-iodine antiseptic in the maintenance of oral health and in the prevention and treatment of common oropharyngeal infections. Int J Clin Pract 2015; 69:1247-56. [PMID: 26249761 PMCID: PMC6767541 DOI: 10.1111/ijcp.12707] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 07/23/2015] [Indexed: 12/14/2022] Open
Abstract
AIMS To better inform medical practitioners on the role of antiseptics in oropharyngeal health and disease, this article focuses on povidone-iodine (PVP-I), an established and widely-available antiseptic agent. METHODOLOGY Review of the anti-infective profile, efficacy and safety of PVP-I in managing common upper respiratory tract infections such as the common cold, influenza and tonsillo-pharyngitis, as well as oral complications resulting from cancer treatment (oral mucositis), and dental conditions (periodontitis, caries). RESULTS Antiseptics with broad-spectrum anti-infective activity and low resistance potential offer an attractive option in both infection control and prevention. While there is some evidence of benefit of antiseptics in a variety of clinical settings that include dental and oral hygiene, dermatology, oncology, and pulmonology, there appears to be discordance between the evidence-base and practice. This is especially apparent in the management and prevention of oropharyngeal infections, for which the use of antiseptics varies considerably between clinical practices, and is in marked contrast to their dermal application, where they are extensively used as both a prophylaxis and a treatment of skin and wound infections, thus minimising the use of antibiotics. CONCLUSION The link between oral and oropharyngeal health status and susceptibility to infection has long been recognised. The high rates of antibiotic misuse and subsequent development of bacterial resistance (e.g. increasing vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA)) in large parts of the world, especially across Asia Pacific, highlight the need for identifying alternative antimicrobials that would minimise the use of these medications. This, together with recent large-scale outbreaks of, for example, avian and swine influenza virus, further underline the importance of an increasing armamentarium for infection prevention and control.
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Affiliation(s)
- J Kanagalingam
- Lee Kong Chian School of Medicine, NTU-Imperial College, Singapore
| | - R Feliciano
- Department of Otolaryngology, St Luke's Medical Center, Global City, Philippines
| | - J H Hah
- Department of Otolaryngology-Head and Neck Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - H Labib
- Dr. Hussein Labib Dental Clinic, Dubai, United Arab Emirates
| | - T A Le
- Department of Oncology, Cho Ray hospital, Ho Chi Minh City, Vietnam
| | - J-C Lin
- Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan
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Pham A, Ye DW, Pal S. Overview and management of toxicities associated with systemic therapies for advanced renal cell carcinoma. Urol Oncol 2015; 33:517-27. [PMID: 26351153 DOI: 10.1016/j.urolonc.2015.07.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 08/14/2015] [Accepted: 08/28/2015] [Indexed: 11/16/2022]
Abstract
The advent of novel targeted agents for metastatic renal cell carcinoma (RCC) has offered clinical benefits over traditional immunotherapy (e.g., interleukin-2 and interferon-α) in both efficacy and safety profiles. The major classes of these targeted therapies for metastatic RCC include the tyrosine-kinase inhibitors, monoclonal antibody against vascular endothelial growth factor, and inhibitors of the mammalian target of rapamycin. Most recently, the success of immune checkpoint inhibitors--notably antibodies directed against programmed death-1 and its ligand--has also been demonstrated in RCC. With such progress in therapy, early detection, and subsequent management of treatment-related adverse events allow for patients to remain on active therapy for as long as possible and also enhance the probability of patients tolerating subsequent second line options. However, despite such impressive gains in efficacy with these new agents, therapeutic progress are primarily palliative in nature--hence, the critical importance of minimizing discomfort and potential harm in this patient population cannot be understated.
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Affiliation(s)
- Anh Pham
- Department of Medical Oncology, City of Hope Comprehensive Cancer Center, Los Angeles, CA
| | - Da-Wei Ye
- Cancer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Sumanta Pal
- Department of Medical Oncology, City of Hope Comprehensive Cancer Center, Los Angeles, CA.
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González Espinoza IR, Villarreal Garza C, Juárez León OA, Adel Álvarez LA, Cruz López JC, Téllez Bernal E. Cáncer de mama con receptores hormonales positivos: tratamiento adyuvante, primera línea en cáncer metastásico y nuevas estrategias (inhibición de mTOR). GACETA MEXICANA DE ONCOLOGÍA 2015. [DOI: 10.1016/j.gamo.2015.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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22
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Miranzadeh S, Adib-Hajbaghery M, Soleymanpoor L, Ehsani M. Effect of adding the herb Achillea millefolium on mouthwash on chemotherapy induced oral mucositis in cancer patients: A double-blind randomized controlled trial. Eur J Oncol Nurs 2015; 19:207-13. [DOI: 10.1016/j.ejon.2014.10.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 09/27/2014] [Accepted: 10/24/2014] [Indexed: 11/30/2022]
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Diaz-Sanchez RM, Pachón-Ibáñez J, Marín-Conde F, Rodríguez-Caballero Á, Gutierrez-Perez JL, Torres-Lagares D. Double-blind, randomized pilot study of bioadhesive chlorhexidine gel in the prevention and treatment of mucositis induced by chemoradiotherapy of head and neck cancer. Med Oral Patol Oral Cir Bucal 2015; 20:e378-85. [PMID: 25662553 PMCID: PMC4464927 DOI: 10.4317/medoral.20338] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 10/26/2014] [Indexed: 12/02/2022] Open
Abstract
Background To evaluate, in an initial way, the effectiveness of bioadhesive chlorhexidine gel 0.2% versus placebo as a preventive and therapeutic intervention of oral mucositis induced by radiation therapy and chemotherapy in patients diagnosed with head and neck cancer treated with chemoradiotherapy. Material and Methods In this pilot study, 7 patients (range of age: 18- 65), having histological documented diagnosis of squamous carcinoma on the head and neck region in stage III and IV, and receiving combined radiation treatment and chemotherapy (cisplatin 100 mg/m2 IV on days 1, 22, and 43 of irradiation) were studied. Simultaneously, a topical application was performed with bioadhesive chlorhexidine gel 0.2% in the study group, and the placebo gel for the control group in 5 applications per day, from the time of initiation of cancer treatment to 2 weeks after completion of chemo-radiotherapy treatment (11 weeks of follow-up). The gradation of mucositis, pain, analgesic consumption, infectious complications, and treatment tolerance was measured. Results After 7 patients completed the protocol, any differences were observed between groups in an interval analysis. Mucositis, pain, and tolerance was similar in both groups. Conclusions Our results must be interpreted with caution due to the reduced sample size, but the use of bioadhesive chlorhexidine gel 0.2% didn’t contribute clinical improvement to the oral mucositis induced by radiation therapy and chemotherapy. Key words:
Chlorhexidine, mucositis, head and neck cancer.
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Affiliation(s)
- Rosa-Maria Diaz-Sanchez
- Departament of Stomatology, School of Dentistry - University of Seville, "Virgen del Rocío" University Hospital, C/ Avicena s/n 41009. Seville, Spain,
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Eilers J, Harris D, Henry K, Johnson LA. Evidence-Based Interventions for Cancer Treatment-Related Mucositis: Putting Evidence Into Practice. Clin J Oncol Nurs 2014; 18 Suppl:80-96. [DOI: 10.1188/14.cjon.s3.80-96] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Miranzadeh S, Adib-Hajbaghery M, Soleymanpoor L, Ehsani M. A New mouthwash for Chemotherapy Induced Stomatitis. Nurs Midwifery Stud 2014; 3:e20249. [PMID: 25699281 PMCID: PMC4332993 DOI: 10.17795/nmsjournal20249] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 07/11/2014] [Accepted: 07/13/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Stomatitis is a disturbing side-effect of chemotherapy that disturbs patients and causes difficulties in patient's drinking, eating and talking, and may results in infection and bleeding. OBJECTIVES This study aimed to investigate the effect of Yarrow distillate in the treatment of chemotherapy-induced stomatitis. PATIENTS AND METHODS This randomized controlled trial study was conducted during 2013. The study population consisted of all cancer patients with chemotherapy-induced oral stomatitis referred to Shahid Beheshti Medical Center, Kashan, Iran. The data collection instrument had two-part; a demographic part and another part recording the severity of the stomatitis at the first, seventh, and 14th days of the intervention based on a WHO criteria checklist in 2005. In this study, 56 patients diagnosed with cancer were randomly assigned into control and experimental groups in similar blocks according to their stomatitis severity. The experimental group gargled 15 mL of a routine solution mixed with Yarrow distillate 4 times a day for 14 days while the control group gargled 15 mL of routine solution. The severity of stomatitis was assessed at the beginning of the intervention, and then after 7 and 14 days of the study. Data were analyzed using chi-square and Fisher exact test, Mann-Whitney U, Kruskal-Wallis, and Friedman tests using SPSS 11.5 software. RESULTS At first, the median score of stomatitis in the experimental group was 2.50 that significantly reduced to 1 and 0 in days 7 and 14 of the intervention, respectively (P value < 0.001). However, in the control group, the median score of stomatitis was 2.50, which significantly increased to 3 in days 7 and 14 (P value < 0.001). CONCLUSIONS Yarrow distillate-contained solution reduced stomatitis severity more than the routine solution. Therefore, we suggest using it in patients with chemotherapy-induced stomatitis.
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Affiliation(s)
- Sedigheh Miranzadeh
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
| | | | - Leyla Soleymanpoor
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Majid Ehsani
- Department of Internal Medicine, Shahid Beheshti Medical Center, Kashan University of Medical Sciences, Kashan, IR Iran
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Role of inhibitors of mammalian target of rapamycin in the treatment of luminal breast cancer. Anticancer Drugs 2013; 24:769-80. [PMID: 23838677 DOI: 10.1097/cad.0b013e328363adc5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Approximately 75% of patients with breast cancer present hormone receptor-positive tumors. This subtype of breast cancer initially shows a high overall response rate to hormonal treatments. However, resistance eventually develops, resulting in tumor progression. The PI3K/Akt/mTOR pathway regulates several cellular functions in cancer such as cell growth, survival, and proliferation. In addition, a high activation level of the PI3K/Akt/mTOR pathway is related to resistance to conventional chemotherapy and hormone therapy. The mTOR inhibitor everolimus, in combination with hormonal treatments, has led to excellent results in progression-free survival in patients with metastatic breast cancer resistant to hormone therapies. Therefore, everolimus has entered the National Comprehensive Cancer Network (NCCN) guidelines 2012 and its combination with exemestane was approved recently by the US Food and Drug Administration and the European Medicines Agency. This is the first time that a drug will have been approved for the restoration of hormone sensitivity in breast cancer.
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Grünwald V, Weikert S, Pavel ME, Hörsch D, Lüftner D, Janni W, Geberth M, Weber MM. Practical management of everolimus-related toxicities in patients with advanced solid tumors. ACTA ACUST UNITED AC 2013; 36:295-302. [PMID: 23689226 DOI: 10.1159/000350625] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Everolimus is an orally administered inhibitor of the mammalian target of rapamycin (mTOR), an intracellular protein kinase downstream of the phosphatidylinositol 3-kinase/AKT pathway involved in key components of tumorigenesis, including cell growth, proliferation, and angiogenesis. In the advanced cancer setting, based on favorable results from phase III trials, everolimus is indicated for the treatment of advanced renal cell carcinoma, advanced neuroendocrine tumors of pancreatic origin, and advanced hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer. Additional oncology indications for everolimus include renal angiomyolipoma with tuberous sclerosis complex and subependymal giant-cell astrocytoma. Although it is generally well tolerated, with most adverse events of mild to moderate severity and manageable, everolimus exhibits a distinct adverse event profile that warrants guidance for proper diagnostic and medical management. This guidance is particularly important given the potential for widespread long-term use of everolimus. This review will focus on the most relevant toxicities associated with mTOR inhibitors and on their management. Practical treatment recommendations are presented for stomatitis, noninfectious pneumonitis, rash, selected metabolic abnormalities, and infections. Provided these events are rapidly identified and treated, the vast majority should resolve with minimal effect on treatment outcomes and patients' quality of life.
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Affiliation(s)
- Viktor Grünwald
- Klinik für Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Germany.
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Qutob AF, Gue S, Revesz T, Logan RM, Keefe D. Prevention of oral mucositis in children receiving cancer therapy: A systematic review and evidence-based analysis. Oral Oncol 2013; 49:102-7. [DOI: 10.1016/j.oraloncology.2012.08.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 08/14/2012] [Accepted: 08/15/2012] [Indexed: 10/27/2022]
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Sahrmann P, Sener B, Ronay V, Attin T, Schmidlin PR. Clearance of topically-applied PVP-iodine as a solution or gel in periodontal pockets in men. Acta Odontol Scand 2012; 70:497-503. [PMID: 22181668 DOI: 10.3109/00016357.2011.640276] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The aim of the study was to investigate the clearance of PVP-iodine applied as a gel or solution in periodontal pockets. METHODS Teeth of 12 subjects with at least eight periodontal pockets of ≥5 mm probing depth were isolated with a rubber dam to allow contamination-free access to the pockets. In each subject, three pockets were filled with PVP-iodine gel (10%) and three with PVP-iodine solution (10%). One pocket of each subject without iodine application served as a negative control. The treatment allocation was assigned randomly. Any excess material was removed subsequently. After 1, 5 and 15 min, a paper point was used to collect the sulcus liquid and the concentration of PVP-iodine was chemically determined. In addition, PVP-iodine gel was administered into 12 periodontal pockets immediately after sub-gingival ultrasound debridement and the concentration of PVP-iodine was determined after 1 min. RESULTS Descending concentrations of PVP-iodine were determined at 1, 5 and 15 min after the application. No PVP-iodine was found in the pockets serving as negative controls. The mean concentrations of the gel and solution were 6.14 μg/ml and 4.44 μg/ml (1 min; p ≥ 0.028), 3.20 μg/ml and 1.44 μg/ml (5 min; p ≥ 0.126), 0.69 μg/ml and 0.23 μg/ml (15 min; p ≤ 0.019), respectively. In the pockets with previous debridement the mean concentration was 1.68 ± 1.97 μg/ml. CONCLUSION The application of PVP-iodine gel in periodontal pockets allows a prolonged remnant effect as compared to that of the solution formula.
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Affiliation(s)
- Philipp Sahrmann
- Clinic for Preventive Dentistry, Periodontology and Cariology, Center for Dental and Oral Medicine and Maxillofacial Surgery, University of Zurich, Switzerland.
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The Role of Mammalian Target of Rapamycin (mTOR) Inhibition in the Treatment of Advanced Breast Cancer. Curr Oncol Rep 2012; 15:14-23. [DOI: 10.1007/s11912-012-0277-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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31
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Lipids in preventive dentistry. Clin Oral Investig 2012; 17:669-85. [DOI: 10.1007/s00784-012-0835-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 08/28/2012] [Indexed: 02/06/2023]
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32
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Choi SE, Kim HS. Sodium Bicarbonate Solution versus Chlorhexidine Mouthwash in Oral Care of Acute Leukemia Patients Undergoing Induction Chemotherapy: A Randomized Controlled Trial. Asian Nurs Res (Korean Soc Nurs Sci) 2012; 6:60-6. [PMID: 25030829 DOI: 10.1016/j.anr.2012.05.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 05/08/2012] [Accepted: 05/08/2012] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The objective of this study was to compare the effectiveness of sodium bicarbonate (SB) solution with chlorhexidine (CHX) mouthwash in oral care of acute leukemia patients under induction chemotherapy. METHODS Forty-eight patients were randomly selected and assigned to an SB solution group or CHX-based product group according to acute myelogenous leukemia or acute lymphoblastic leukemia. Patients were asked to rinse their mouth four times a day from the day before chemotherapy started until discharge. The World Health Organization mucositis grade, patient-reported Oral Mucositis Daily Questionnaire, and clinical signs associated with infection were assessed on a daily basis. The oral microbial count was assessed on a weekly basis from the 1st day of chemotherapy started to the 28th day or to the day of discharge from the hospital. RESULTS Of all the patients in the SB group, 25.0% developed ulcerative oral mucositis, whereas 62.5% in the CHX group did. The onset of oral mucositis was later in the SB group than the CHX group. The oral bacterial colonization in the SB group was significantly higher than that in the CHX group, but clinical signs associated with infection did not differ in both groups. CONCLUSION As a result of this study, it was found that oral care by SB solution for acute leukemia patients undergoing chemotherapy was an effective intervention to improve oral health.
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Affiliation(s)
- So-Eun Choi
- Department of Nursing, Nambu University, Gwangju, South Korea
| | - Hee-Seung Kim
- College of Nursing, The Catholic University, Seoul, South Korea
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Villarreal-Garza C, Cortes J, Andre F, Verma S. mTOR inhibitors in the management of hormone receptor-positive breast cancer: the latest evidence and future directions. Ann Oncol 2012; 23:2526-2535. [PMID: 22553196 DOI: 10.1093/annonc/mds075] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND There is an unmet therapeutic need in endocrine-resistant, hormone receptor (HR)-positive, human epidermal growth factor receptor 2-negative advanced breast cancer (BC). Preclinical studies support the hypothesis that the mammalian target of rapamycin (mTOR) inhibition could potentially overcome resistance to endocrine therapy. MATERIALS AND METHODS A literature review regarding BC and mTOR inhibitors was undertaken. The reference lists from retrieved manuscripts were reviewed to identify further studies. RESULTS Phase II studies have reported that the combination of mTOR inhibitors with endocrine therapy shows efficacy in patients with advanced disease that progressed after treatment with aromatase inhibitors. The recent findings of the phase III BOLERO-2 confirmed that everolimus in combination with exemestane significantly improved progression-free survival and response rate, with a manageable safety profile. CONCLUSIONS The addition of everolimus to exemestane for women with HR-positive metastatic BC is now considered a new therapeutic strategy. However, a word of caution should be added regarding toxic effects, which might limit practical use and compliance. It is essential that clinicians are educated about key recommendations for toxicity management and specific guideline dose modifications. Additional research efforts with the addition of these compounds in the early-stage setting is greatly needed to improve the survival of patients with HR-positive BC.
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Affiliation(s)
- C Villarreal-Garza
- Department of Medical Oncology, Instituto Nacional de Cancerologia, Mexico DF, Mexico
| | - J Cortes
- Breast Cancer Unit, Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - F Andre
- Breast Cancer Unit, Department of Medical Oncology, University Paris XI and Institut Gustave Roussy, Villejuif, France
| | - S Verma
- Department of Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, Canada.
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Ota Y, Morito A, Fujisawa K, Nishida M, Hata H, Ueno T, Yurikusa T, Murata T. Evaluation of a moisturising micro-gel spray for prevention of cell dryness in oral mucosal cells: an in vitro study and evaluation in a clinical setting. Eur J Cancer Care (Engl) 2012; 21:728-34. [PMID: 22519950 PMCID: PMC3533771 DOI: 10.1111/j.1365-2354.2012.01349.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
A moisturising micro-gel spray for prevention of dryness was compared with commercial products and artificial saliva in vitro and in a clinical setting in patients with cancer. Survival of cultured human gingival epithelial cells was evaluated after treatment with each product for 15 min. A dry test was performed for products giving a 50% survival rate, in which cell survival was measured after drying of cells treated with each product. The survival rates of cells treated with the micro-gel spray and artificial saliva were significantly higher than those of control cells. The micro-gel spray was then evaluated for 1 week in patients with symptoms of dry mouth caused by cancer treatment. There was significant improvement of these symptoms at night and on awakening and of subjective symptoms of decreased salivary volume (P < 0.05). Mean visual analogue scale scores also significantly decreased (P < 0.01). These data suggest that evaluation of moisturising products for dryness prevention can be performed in cultured cells, since products that performed well in vitro also showed good efficacy for symptoms of dry mouth. The micro-gel spray was particularly effective for relieving symptoms of dry mouth in patients with cancer.
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Affiliation(s)
- Y Ota
- Dental and Oral Surgery Division, Shizuoka Cancer Center Hospital, Shizuoka, Japan.
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Snowden JA, Ahmedzai SH, Ashcroft J, D’Sa S, Littlewood T, Low E, Lucraft H, Maclean R, Feyler S, Pratt G, Bird JM. Guidelines for supportive care in multiple myeloma 2011. Br J Haematol 2011; 154:76-103. [DOI: 10.1111/j.1365-2141.2011.08574.x] [Citation(s) in RCA: 151] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Porta C, Osanto S, Ravaud A, Climent MA, Vaishampayan U, White DA, Creel P, Dickow B, Fischer P, Gornell SS, Meloni F, Motzer RJ. Management of adverse events associated with the use of everolimus in patients with advanced renal cell carcinoma. Eur J Cancer 2011; 47:1287-98. [PMID: 21481584 DOI: 10.1016/j.ejca.2011.02.014] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Revised: 02/15/2011] [Accepted: 02/18/2011] [Indexed: 01/29/2023]
Abstract
PURPOSE In April 2009, an expert group of 11 physicians and clinical nurses met to discuss the management of selected adverse events associated with the use of everolimus for the treatment of metastatic renal cell carcinoma (mRCC). Everolimus is an orally administered inhibitor of the mammalian target of rapamycin that recently received approval from the European Medicines Agency for the treatment of advanced RCC that has progressed on or after treatment with vascular endothelial growth factor (VEGF)-targeted therapy, and from the United States Food and Drug Administration for treatment of advanced RCC after failure of sorafenib or sunitinib. Before the approval of everolimus, no standard therapy existed for the treatment of mRCC after failure of VEGF-targeted therapy. RECORD-1 (Renal Cell cancer treatment with Oral RAD001 given Daily) was the pivotal multicenter, phase III, randomised, double-blind, placebo-controlled trial of everolimus that led to approval for patients with disease progression on or after treatment with VEGF-targeted agents. Safety data from RECORD-1 were reviewed by these clinicians, all of whom had experience using everolimus in patients with mRCC. Adverse events discussed were non-infectious pneumonitis, infections, stomatitis and metabolic abnormalities. RESULTS The outcome of this discussion is summarised here. Guidance for management of these adverse events is provided. Both clinicians and patients should be aware of the potential side-effects of everolimus and understand that these side-effects are manageable with standard care to optimise patient benefit.
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Affiliation(s)
- Camillo Porta
- IRCCS San Matteo University Hospital Foundation, Pavia, Italy.
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Abstract
Mucosal barrier injury (MBI), also known as mucositis, is the result of the cytotoxic effects of many treatments given for hematological malignancies (HMs) and represents a major source of potentially devastating clinical complications and negative consequences afflicting the patient's management, such as a longer hospitalization, the need of analgesic and total parenteral nutrition use, and increased costs. The available measures for the prevention and treatment of MBI have been substantially limited to the control of pain, infection, bleeding and nutrition. However, in the last decade, a better insight into the complex pathogenesis of MBI has led to the development of novel therapeutic options, such as palifermin, which has been one of the major breakthroughs in the management of this condition, potentially allowing a targeted approach to MBI. Nevertheless, and despite these significant advances, MBI still remains a significant clinical problem in the management of HM and an important burden of sufferance for afflicted patients.
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Affiliation(s)
- Pasquale Niscola
- Hematology Unit, S. Eugenio Hospital, Piazzale dell'Umanesimo 10, Rome, Italy.
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Eduardo FDP, Bezinelli LM, Hamerschlak N, Andrade CT, Morelli LR, Corrêa L. Oral care in Brazilian bone marrow transplant centers. Rev Bras Hematol Hemoter 2011; 33:15-20. [PMID: 23284237 PMCID: PMC3521429 DOI: 10.5581/1516-8484.20110008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Accepted: 10/05/2010] [Indexed: 11/30/2022] Open
Abstract
Background Oral care is a fundamental procedure for the success of the hematopoietic stem cell transplantation, particularly regarding the control of oral infectious diseases. Information about oral care protocols and the inclusion of dental professionals in transplantation medical staff is poorly known. Objective The aim of this study was to carry out a survey about the protocols of Brazilian dental professionals with regard to oral care of HSCT patients. Methods A questionnaire was mailed to 36 Brazilian transplant centers with questions about basic oral care protocols, the indication of specific mouthwashes, antibiotic therapy regimens, laser therapy, and treatment of oral mucositis and graft-versus-host disease. All the respondent centers (n = 12) have dentists as members of the HSCT medical staff. Results The majority indicate non-alcoholic chlorhexidine (n = 9; 75.0%) and sodium bicarbonate (n = 5; 41.7%) as routine mouthwashes. Laser therapy was frequently indicated (n= 9; 75.0%), mainly in the prevention of oral mucositis and in oral pain control. In the post-transplant period, antibiotic therapy was only indicated for invasive dental treatments (n= 8; 66.7%). Several treatments for graft-versus-host disease were mentioned without a trend towards establishing a standard protocol. Conclusion Basic oral care constitutes regular assessment in the routine treatment of hematopoietic stem cell transplantation patients in Brazilian centers.
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Gastrointestinal Malignancies. Palliat Care 2011. [DOI: 10.1016/b978-1-4377-1619-1.00029-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Napeñas JJ, Brennan MT, Coleman S, Kent ML, Noll J, Frenette G, Nussbaum ML, Mougeot JL, Paster BJ, Lockhart PB, Bahrani-Mougeot FK. Molecular methodology to assess the impact of cancer chemotherapy on the oral bacterial flora: a pilot study. ACTA ACUST UNITED AC 2010; 109:554-60. [PMID: 20303053 DOI: 10.1016/j.tripleo.2009.11.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 11/12/2009] [Accepted: 11/13/2009] [Indexed: 01/24/2023]
Abstract
OBJECTIVE This pilot study determined the profile of the oral bacterial flora in an outpatient cancer population before and after chemotherapy using molecular techniques. STUDY DESIGN We recruited 9 newly diagnosed breast cancer patients scheduled for induction chemotherapy. All were seen immediately before chemotherapy, and 7 to 14 days later. At both visits, we performed oral evaluations and obtained mucositis grading (with the World Health Organization [WHO] scale), absolute neutrophil counts (ANC), and bacterial samples from the buccal mucosa. Bacterial DNA was isolated, and 16S ribosomal RNA gene clonal libraries were constructed. Sequences of genes in the library were used to determine species identity by comparison to known sequences. RESULTS After chemotherapy, WHO scores of 0 and 1 were in 3 and 6 patients, respectively, and mean ANC (+/-SD) dropped from 3326 +/- 463 to 1091 +/- 1082 cells/mm(3). From pre- and post-chemotherapy samples, 41 species were detected, with a predominance of Gemella haemolysans and Streptococcus mitis. More than 85% of species have not been previously identified in chemotherapy patients. Seven species appeared exclusively before chemotherapy and 25 after chemotherapy. After chemotherapy, the number of species per patient increased by a mean of 2.6 (SD = 4.7, P = .052). CONCLUSION We identified species not previously identified in chemotherapy patients. Our results suggest a shift to a more complex oral bacterial profile in patients undergoing cancer chemotherapy.
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Affiliation(s)
- Joel J Napeñas
- Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC 28232, USA.
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Vayne-Bossert P, Escher M, de Vautibault CG, Dulguerov P, Allal A, Desmeules J, Herrmann FR, Pautex S. Effect of Topical Morphine (Mouthwash) on Oral Pain Due to Chemotherapy- and/or Radiotherapy-Induced Mucositis: A Randomized Double-Blinded Study. J Palliat Med 2010; 13:125-8. [DOI: 10.1089/jpm.2009.0195] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Monica Escher
- Division of Clinical Toxicology and Pharmacology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | | | - Pavel Dulguerov
- Division of Otolaryngology and Head and Neck Surgery, University Hospital Geneva, Geneva, Switzerland
| | | | - Jules Desmeules
- Division of Clinical Toxicology and Pharmacology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - François R. Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Sophie Pautex
- Division of Palliative Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
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Santos FA, Pochapski MT, Pilatti GL, Kozlowski Jr VA, Goiris FAJ, Groppo FC. Severe necrotizing stomatitis and osteomyelitis after chemotherapy for acute leukaemia. Aust Dent J 2009; 54:262-5. [DOI: 10.1111/j.1834-7819.2009.01129.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Panahi Y, Ala S, Saeedi M, Okhovatian A, Bazzaz N, Naghizadeh MM. Allopurinol mouth rinse for prophylaxis of fluorouracil-induced mucositis. Eur J Cancer Care (Engl) 2009; 19:308-12. [PMID: 19659665 DOI: 10.1111/j.1365-2354.2008.01042.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To prepare and evaluate an allopurinol mouth rinse for prophylaxis of fluorouracil-induced mucositis, 33 patients with malignant disorders, who were going to receive 5-fluorouracil containing chemotherapy, were enrolled in a placebo-controlled double-blinded randomized clinical trial. Allopurinol mouthwash (1 mg/ml) or placebo was administered 1, 2 and 3 h after chemotherapy and three consecutive nights. A questionnaire consisting of demographic parameters, medical status, quality of life survey and mucosal injury scoring table (based on World Health Organization scales for mucositis) was completed for each patient at Day 1, 3 and 7 after chemotherapy. In allopurinol group nine participants (60.0%) were female and in placebo group, 10 (66.7%) (P = 0.705). Mean ages were 56.9 +/- 10.3 and 49.5 +/- 13.8 years in allopurinol and placebo groups respectively (P = 0.107). The analysis showed that the higher education level and the use of dentures significantly reduced the occurrence of mucositis, and allopurinol mouth rinse (1 mg/ml) was ineffective in the prophylaxis of fluorouracil-induced mucositis.
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Affiliation(s)
- Y Panahi
- Research Center of Chemical Injuries, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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Welk A, Meller C, Schubert R, Schwahn C, Kramer A, Below H. Effect of lactoperoxidase on the antimicrobial effectiveness of the thiocyanate hydrogen peroxide combination in a quantitative suspension test. BMC Microbiol 2009; 9:134. [PMID: 19589149 PMCID: PMC2715409 DOI: 10.1186/1471-2180-9-134] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2008] [Accepted: 07/09/2009] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The positive antimicrobial effects of increasing concentrations of thiocyanate (SCN-) and H2O2 on the human peroxidase defence system are well known. However, little is known about the quantitative efficacy of the human peroxidase thiocyanate H2O2 system regarding Streptococcus mutans and sanguinis, as well as Candida albicans. The aim of this study was to evaluate the effect of the enzyme lactoperoxidase on the bactericidal and fungicidal effectiveness of a thiocyanate-H2O2 combination above the physiological saliva level. To evaluate the optimal effectiveness curve, the exposure times were restricted to 1, 3, 5, and 15 min. RESULTS The bactericidal and fungicidal effects of lactoperoxidase on Streptococcus mutans and sanguinis and Candida albicans were evaluated by using two test mixtures of a 2.0% (w/v; 0.34 M) thiocyanate and 0.4% (w/v; 0.12 M) hydrogen peroxide solution, one without and one with lactoperoxidase. Following the quantitative suspension tests (EN 1040 and EN 1275), the growth of surviving bacteria and fungi in a nutrient broth was measured. The reduction factor in the suspension test without lactoperoxidase enzyme was < 1 for all three tested organisms. Thus, the mixtures of 2.0% (w/v; 0.34 M) thiocyanate and 0.4% (w/v; 0.12 M) hydrogen peroxide had no in vitro antimicrobial effect on Streptococcus mutans and sanguinis or Candida albicans. However, the suspension test with lactoperoxidase showed a high bactericidal and fungicidal effectiveness in vitro. CONCLUSION The tested thiocyanate and H2O2 mixtures showed no relevant antimicrobial effect. However, by adding lactoperoxidase enzyme, the mixtures became not only an effective bactericidal (Streptococcus mutans and sanguinis) but also a fungicidal (Candida albicans) agent.
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Affiliation(s)
- A Welk
- Department of Restorative Dentistry, Periodontology and Endodontology, Dental School, University of Greifswald, Greifswald, Germany
| | - Ch Meller
- Department of Operative Dentistry and Periodontology, Center of Dentistry, Oral Medicine, and Maxillofacial Surgery, University Hospital Tuebingen, Tuebingen, Germany
| | - R Schubert
- Private dental practice, Berlin, Germany
| | - Ch Schwahn
- Department of Restorative Dentistry, Periodontology and Endodontology, Dental School, University of Greifswald, Greifswald, Germany
| | - A Kramer
- Institute of Hygiene and Environmental Medicine, University of Greifswald, Greifswald, Germany
| | - H Below
- Institute of Hygiene and Environmental Medicine, University of Greifswald, Greifswald, Germany
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Takuma D, Guangchen S, Yokota J, Hamada A, Onogawa M, Yoshioka S, Kusunose M, Miyamura M, Kyotani S, Nishioka Y. Effect of Eriobotrya japonica Seed Extract on 5-Fluorouracil-Induced Mucositis in Hamsters. Biol Pharm Bull 2008; 31:250-4. [DOI: 10.1248/bpb.31.250] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Daisuke Takuma
- Department of Biomedical Science, Kochi Medical Graduate School
| | - Sun Guangchen
- Department of Biomedical Science, Kochi Medical Graduate School
| | | | | | - Masahide Onogawa
- Department of Biomedical Science, Kochi Medical Graduate School
- Department of Pharmacy, Kochi Medical School Hospital
| | | | | | | | | | - Yutaka Nishioka
- Department of Biomedical Science, Kochi Medical Graduate School
- Department of Pharmacy, Kochi Medical School Hospital
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2007. [DOI: 10.1002/pds.1378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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