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Mamgain RK, Gupta M, Mamgain P, Verma SK, Pruthi DS, Kandwal A, Saini S. The efficacy of an ayurvedic preparation of yashtimadhu ( Glycyrrhiza glabra) on radiation-induced mucositis in head-and-neck cancer patients: A pilot study. J Cancer Res Ther 2020; 16:458-462. [PMID: 32719251 DOI: 10.4103/jcrt.jcrt_831_16] [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: 11/04/2022]
Abstract
Background Oral mucositis is a common and debilitating painful side effect of many forms of chemotherapy and radiation therapy. Mucositis may lead to dose reductions and unplanned interruptions of chemotherapy and/or radiotherapy (RT) and often affects patients' quality of life. Aim The objective of the study was to assess the efficacy of the ayurvedic preparation in decreasing the severity of mucositis in head-and-neck cancer patients receiving concomitant chemoradiotherapy. Materials and Methods In this prospective randomized study, the patients were divided into three groups. Group 1 patients received conventional mucositis treatment, whereas Group 2 patients received ayurvedic preparation Yashtimadhu in addition to conventional treatment. Group 3 patients received honey for local application in oral cavity as well as one tea spoon of honey twice daily orally in addition to routine conventional treatment. All the patients were assessed for mucositis at the end of every week during the RT for a period of 6 weeks. Results A significant difference was observed between the groups at each time point. Nearly 42.85% of patients in conventional treatment arm developed Grade 3 mucositis, 20% of patients developed Grade 3 mucositis in group where honey was given, and only 15.5% of patients developed Grade 3 mucositis in Yastimadhu group. Unplanned treatment breaks and hospitalization of patients were reduced with the use of yashtimadhu as compared to other two groups. Conclusion Yashtimadhu was observed to be effective and delayed the development of severe form of mucositis. The drug appeared to be more efficient in the management of radiation-induced mucositis.
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Affiliation(s)
- Ravindra Kumar Mamgain
- Department of Ayurvedic Medicine, Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Meenu Gupta
- Department of Radiation Oncology, Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Pratibha Mamgain
- Department of Ayurvedic Medicine, Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Sanjeev Kumar Verma
- Department of Medicine, Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Deep Shankar Pruthi
- Department of Radiation Oncology, Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Abhishek Kandwal
- Department of Dental Surgery, Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Sunil Saini
- Department of Surgery, Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
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Hirakawa H, Ikegami T, Azechi S, Agena S, Uezato J, Kinjyo H, Yamashita Y, Tanaka K, Kondo S, Maeda H, Suzuki M, Gahana A. ERCC1 C8092A polymorphism predicts fair survival outcome in Japanese patients with pharyngo-laryngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol 2019; 277:601-610. [PMID: 31749055 DOI: 10.1007/s00405-019-05731-y] [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: 08/05/2019] [Accepted: 11/09/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE To evaluate the prognostic significance of DNA excision repair gene polymorphisms, excision repair cross-complementation group 1 (ERCC1) and X-ray repair complementing defective repair in Chinese hamster cells 1 (XRCC1) polymorphisms were investigated in Japanese patients with head and neck squamous cell carcinoma (HNSCC). METHODS A total of 225 consecutive patients with HNSCC who underwent surgery or chemoradiotherapy/radiotherapy (CRT/RT) with curative intent as primary treatment from 2006 to 2017 were recruited. ERCC1 C8092A and XRCC1 Arg399Gln polymorphisms in DNA extracted from individual blood samples were determined by the polymerase chain reaction-restriction fragment length polymorphism method. Cumulative survival was estimated by Kaplan-Meier analysis with a log-rank test and Cox proportional hazards model stratified by treatment arm, adjusting for clinical prognostic factors. RESULTS Multivariate analysis showed that carriers with the ERCC1 8092 (C/A+A/A) genotype (hazard ratio, 3.56; 95% confidence interval, 1.22-7.39; p = 0.02) had significantly worse survival than those with ERCC1 8092 C/C who received CRT/RT. Conversely, the XRCC1 Arg399Gln polymorphism did not influence survival in patients who received CRT/RT as well as surgery. CONCLUSION The ERCC1 C8092A polymorphism might be an independent predictor of response to CRT and survival outcome in patients with HNSCC. This is the first report to investigate the role of DNA excision repair gene polymorphisms in patients with head and neck cancer in a Japanese population.
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Affiliation(s)
- Hitoshi Hirakawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan.
| | - Taro Ikegami
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan
| | - Satoe Azechi
- School of Medicine, Tokai University, Kasouya, Iseharashi, Kanagawa, 259-1193, Japan
| | - Shinya Agena
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan
| | - Jin Uezato
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan
| | - Hidetoshi Kinjyo
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan
| | - Yukashi Yamashita
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan
| | - Katsunori Tanaka
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan
| | - Shunsuke Kondo
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan
| | - Hiroyuki Maeda
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan
| | - Mikio Suzuki
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan
| | - Akira Gahana
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan.,Department of Otorhinolaryngology-Head and Neck Surgery, University of Miyazaki, Miyazaki, 889-1692, Japan
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De La Torre A, Romero J, Montero A, Garcia-Berrocal MI, Valcarcel FJ, Cordoba S, Magallon R. Radiochemotherapy with Cisplatin and Oral Tegafur in Advanced Head and Neck Cancer: Long-Term Results of a Phase II Study. TUMORI JOURNAL 2018; 94:453-8. [DOI: 10.1177/030089160809400402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and Background To evaluate the tolerance and efficacy of an original concurrent radiochemotherapy regimen in locally advanced head and neck cancer. Methods Sixty-four patients with stage III or IV squamous cell carcinoma arising from a head and neck mucosal site were eligible. Simultaneous radiochemotherapy consisted of two courses of continuous infusional cisplatin (20 mg/m2/d, days 1–4 and 29–32) and oral tegafur (1200 mg/d, days 1–14 and 29–43), together with conventional radiation therapy up to a total dose of 70–75 Gy over nine weeks. Results All the patients were evaluated for toxicity and response. Acute mucositis was the most prevalent complication. Grade 3 toxicities were mucositis (44%), skin toxicity (10%), leukopenia (8%), and thrombocytopenia (1%). No toxic death was observed. Complete response to treatment was observed in 72% of patients. With a median follow-up of 48.5 months (range, 27–84), 5-year actuarial rate of local-regional control, disease-free survival, overall survival and disease-specific survival were 60% (95% confidence interval [CI], 40–70%), 55% (95% CI, 45–65%), 51% (95% CI, 43–59%) and 61% (95% CI, 53–69%), respectively. Conclusions Response, local-regional control and survival rates are equivalent to those reported from other concomitant radiochemotherapy combinations. However, the regimen offers the advantage of its tolerance and toxicity profile.
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Affiliation(s)
- Alejandro De La Torre
- Department of Radiation Oncology, University Hospital “Clínica Puerta de Hierro”, Madrid, Spain
| | - Jesus Romero
- Department of Radiation Oncology, University Hospital “Clínica Puerta de Hierro”, Madrid, Spain
| | - Angel Montero
- Department of Radiation Oncology, University Hospital “Clínica Puerta de Hierro”, Madrid, Spain
| | | | - Francisco J Valcarcel
- Department of Radiation Oncology, University Hospital “Clínica Puerta de Hierro”, Madrid, Spain
| | - Sofia Cordoba
- Department of Radiation Oncology, University Hospital “Clínica Puerta de Hierro”, Madrid, Spain
| | - Rosa Magallon
- Department of Radiation Oncology, University Hospital “Clínica Puerta de Hierro”, Madrid, Spain
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The effect of topical application of royal jelly on chemoradiotherapy-induced mucositis in head and neck cancer: a preliminary study. Int J Otolaryngol 2014; 2014:974967. [PMID: 25400667 PMCID: PMC4221863 DOI: 10.1155/2014/974967] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 10/06/2014] [Accepted: 10/06/2014] [Indexed: 12/04/2022] Open
Abstract
Purpose. One of the common side effects experienced by head and neck cancer patients on chemoradiotherapy is mucositis. Severe mucositis may be controllable by limiting cancer therapy, but it has resulted in decreasing the completion rate of chemoradiotherapy. The efficacy of royal jelly (RJ) as prophylaxis against chemoradiotherapy-induced mucositis was evaluated through clinical scoring of oral and pharyngeal mucositis. Methods. In this randomized, single-blind (physician-blind), clinical trial, 13 patients with head and neck cancer requiring chemoradiation were randomly assigned to two groups. Seven patients assigned to the study group received RJ, and 6 patients were assigned to the control group. RJ group patients took RJ three times per day during treatment. The patients in both groups were evaluated twice a week for the development of mucositis using Common Terminology Criteria for Adverse Events version 3.0. Results. A significant reduction in mucositis was seen among RJ-treated patients compared with controls (P < 0.001). Conclusion. This study demonstrated that prophylactic use of RJ was effective in reducing mucositis induced by chemoradiotherapy in head and neck cancer patients. However, further studies are needed because of the small sample size and the absence of double blinding.
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Murakami R, Nishimura R, Baba Y, Yumoto E, Oya N, Yamashita Y. Concurrent chemoradiation therapy with low-dose CDDP and UFT for glottic carcinomas: evaluation using the sixth edition of the UICC TNM staging system. Acta Oncol 2009; 45:162-7. [PMID: 16546861 DOI: 10.1080/02841860500490269] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We evaluated whether low-dose chemotherapy could improve effects of radiation therapy for glottic carcinoma with different prognostic factor based on the UICC 6th edition. Fifty-one patients with T2N0 glottic carcinoma classified by the UICC 5th edition underwent chemoradiation therapy with low-dose CDDP (4 mg/m(2)) and oral UFT (450 mg of tegafur) continuing for four weeks (CRT group). The historical control consisted of 49 patients treated with radiation therapy alone (RT group). Forty-six tumors with the adjacent sign, i.e. tumors located adjacent to the thyroid cartilage on radiological examinations, were classified as T3 according to the 6(th) edition. The 5-year local control and laryngeal preservation rates of the T2 (n=54) vs. T3 (n=46) lesions were 87% vs. 50% (p<0.0001) and 94% vs. 61% (p<0.0001), respectively. Among the T3 lesions, CRT (n=24) yielded significantly higher laryngeal preservation rates than did RT alone (n=22) (83% vs. 40%, p=0.0063), and the local control rates were higher in the CRT- than the RT group (62% vs. 36%, p=0.0882). While such benefits of CRT were not observed in patients with T2 lesions.
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Affiliation(s)
- Ryuji Murakami
- Department of Radiation Oncology, Kumamoto University Hospital, Japan.
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Kohno N. The role of chemotherapy for advanced oro and hypopharyngeal cancer. Auris Nasus Larynx 2004; 31:113-8. [PMID: 15121218 DOI: 10.1016/j.anl.2004.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2003] [Accepted: 02/17/2004] [Indexed: 11/19/2022]
Abstract
Although important progress continuous to be made in the treatment of oro and hypopharyngeal cancer, the 5-year survival rate for all this disease has remained at less than 30% for the past 30 years. In the early 1980s, chemotherapy was introduced with high expectation of reducing in the incidence of distant metastases and increasing the possibility of local control. This article explores the use of chemotherapy in the treatment of advanced pharyngeal cancer. Thus, the efficacy of chemotherapy are reviewed and treatment options for advanced pharyngeal cancer are made. When advanced carcinoma is still localized, function-preserving surgery is performed. In these cases, the possibility of instituting adjuvant chemotherapy with an active treatment regimen may be taken into account depending on the condition of the patient and the tumor. Patients with surgically resectable tumors are given 1-2 cycles of induction chemotherapy. Cases who respond to the induction chemotherapy are subsequently given concurrent chemoradiotherapy. Residual lymph nodes in the neck are removed surgically. The cases who do not respond to the induction chemotherapy are treated with radical surgery. Patients with unresectable carcinoma are given concurrent chemoradiotherapy because local treatment should be performed in such patients as early as possible. In principle, concurrent regimens should be supplemented with adjuvant chemotherapy in all cases. This is particularly required for those with advanced N-stage patients.
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Affiliation(s)
- Naoyuki Kohno
- Department of Otolaryngology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.
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