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Villegas-Becerril E, Jimenez-Garcia C, Perula-de Torres L, Espinosa-Calvo M, Bueno-Serrano C, Romero-Ruperto F, Gines-Santiago F, Moreno-Manzanaro M, Muñoz-Gavilan J, Montes-Redondo G, Quesada-Roman M, Linares-Ramirez M, Parras-Rejano J, Muñoz-Alcaraz N, Maestre-Serrano M, Romero-Rodriguez E. Efficacy of an aloe vera, chamomile, and thyme cosmetic cream for the prophylaxis and treatment of mild dermatitis induced by radiation therapy in breast cancer patients (the Alantel study). Contemp Clin Trials Commun 2024; 39:101288. [PMID: 38616815 PMCID: PMC11010796 DOI: 10.1016/j.conctc.2024.101288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/27/2024] [Accepted: 03/26/2024] [Indexed: 04/16/2024] Open
Abstract
Objectives Radiation-induced dermatitis (RD) is one of the most common toxicities in radiation therapy (RT) patients. Corticosteroids, immunosuppressants, and natural products (NPs) have been used as treatment. The objective was to evaluate the efficacy of a NPs-based cream (Alantel®) to reduce the incidence of RD in women with breast cancer undergoing RT treatment. Design We conducted a controlled, randomized, double-blind clinical trial. Setting Radiation Oncology Unit of the Reina Sofía Hospital and 5 Primary Care centers of the Cordoba and Guadalquivir Health District (Spain). Interventions Patients assigned to the experimental group (GTA) were treated with Alantel, while those in the control group (GTE) were treated with a moisturizer and emollient cream. Main outcome measures The primary outcome variable was the incidence of RD. RD-free time, duration of RD, quality of life, and product safety were also assessed. Results Seventy patients were included in the study, 35 in the GTA and 35 in the GTE. The incidence of RD was lower in the GTA (71.4%) than in the GTE (91.4%) after 4 weeks of follow-up (RR = 0.78; NNT = 5; p < 0.031). The Skindex-29 questionnaire showed differences in the statement: "My skin condition makes it hard to work or do hobbies" (17.1% in the GTE vs. 2.9% in GTA; p = 0.024). Conclusions The higher efficacy of Alantel® compared to the control cream in reducing the incidence of RD in women with breast cancer has been demonstrated.
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Affiliation(s)
- E. Villegas-Becerril
- Maimonides Institute for Biomedical Research IMIBIC, Cordoba University, 14004, Cordoba, Spain
- Maser Clinic, Cordoba, Spain
| | - C. Jimenez-Garcia
- Maimonides Institute for Biomedical Research IMIBIC, Cordoba University, 14004, Cordoba, Spain
- Epidemiology Service, Cordoba-Guadalquivir Health District, 14011 Cordoba, Spain
| | - L.A. Perula-de Torres
- Maimonides Institute for Biomedical Research IMIBIC, Cordoba University, 14004, Cordoba, Spain
- Research Network on Chronicity, Primary Care and Prevention and Health Promotion RICAPS-ISCIII, Cordoba, Spain
| | - M. Espinosa-Calvo
- Radiotherapy Oncology Service. Reina Sofia University Hospital, Cordoba, Spain
| | - C.M. Bueno-Serrano
- Radiotherapy Oncology Service. Reina Sofia University Hospital, Cordoba, Spain
| | - F. Romero-Ruperto
- Radiotherapy Oncology Service. Reina Sofia University Hospital, Cordoba, Spain
| | - F. Gines-Santiago
- Radiotherapy Oncology Service. Reina Sofia University Hospital, Cordoba, Spain
| | | | - J.J. Muñoz-Gavilan
- Lucano Clinical Management Unit, Cordoba-Guadalquivir Health District, Cordoba, Spain
| | - G. Montes-Redondo
- Maimonides Institute for Biomedical Research IMIBIC, Cordoba University, 14004, Cordoba, Spain
- Cordoba-Guadalquivir Health District, Maimonides Institute for Biomedical Research (IMIBIC), Cordoba, Spain
- Santa Rosa Clinical Management Unit, Cordoba-Guadalquivir Health District, Cordoba, Spain
| | - M.A. Quesada-Roman
- Lucano Clinical Management Unit, Cordoba-Guadalquivir Health District, Cordoba, Spain
| | - M.C. Linares-Ramirez
- Santa Rosa Clinical Management Unit, Cordoba-Guadalquivir Health District, Cordoba, Spain
| | - J.M. Parras-Rejano
- Maimonides Institute for Biomedical Research IMIBIC, Cordoba University, 14004, Cordoba, Spain
- Huerta de la Reina Clinical Management Unit, Cordoba-Guadalquivir Health District, Maimonides Institute for Biomedical Research IMIBIC, Cordoba, Spain
| | - N. Muñoz-Alcaraz
- Maimonides Institute for Biomedical Research IMIBIC, Cordoba University, 14004, Cordoba, Spain
- Support System of the Cordoba-Guadalquivir Health District, Maimonides Institute for Biomedical Research IMIBIC, Cordoba, Spain
| | - M.D. Maestre-Serrano
- Lucano Clinical Management Unit, Cordoba-Guadalquivir Health District, Cordoba, Spain
| | - E.M. Romero-Rodriguez
- Maimonides Institute for Biomedical Research IMIBIC, Cordoba University, 14004, Cordoba, Spain
- Cordoba-Guadalquivir Health District, Maimonides Institute for Biomedical Research (IMIBIC), Cordoba, Spain
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Kaur S, Bains K. Aloe Barbadensis Miller (Aloe Vera). INT J VITAM NUTR RES 2024; 94:308-321. [PMID: 37915246 DOI: 10.1024/0300-9831/a000797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
Aloe Barbadensis Miller (Aloe Vera, AV) is a widely recognized for its diverse health-promoting, skin care, and medicinal properties. This narrative review provides a comprehensive overview of AV's bioactive compounds, pharmacological activities, potential applications, its toxic and adverse effects, as well as the clinical evidence supporting AV's efficacy in disease prevention. AV contains over 200 bioactive compounds, with the inner clear gel of the leaves containing the majority of these compounds. These include phenolic acids (274.5-307.5 mg/100 g), flavonoids. (3.63-4.70 g/kg), polysaccharides (3.82-6.55 g/kg), saponins, alkaloids, terpenoids, and anthraquinone derivatives. Findings from clinical studies involving both humans and animals highlight the therapeutic potential of AV across diverse health domains. The studies demonstrate AV's efficacy in reducing blood glucose levels, exhibiting antioxidant and immunomodulatory effects, inducing apoptosis in cancer cells, protecting the liver from damage, and displaying antimicrobial properties. In the fields of dermatology and dentistry, AV has also been observed to promote skin and oral health. However, it is imperative to acknowledge potential risks, adhere to recommended dosages, and seek guidance from healthcare experts before employing AV as a natural therapeutic option. Moreover, considering safety concerns, further well-designed randomized controlled trials are necessary to substantiate the potential benefits of AV and comprehensively assess any associated risks.
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Affiliation(s)
- Sukhdeep Kaur
- Department of Food & Nutrition, Punjab Agricultural University, Ludhiana, Punjab, India
| | - Kiran Bains
- Department of Food & Nutrition, Punjab Agricultural University, Ludhiana, Punjab, India
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Wang T, Liao J, Zheng L, Zhou Y, Jin Q, Wu Y. Aloe vera for prevention of radiation-induced dermatitis: A systematic review and cumulative analysis of randomized controlled trials. Front Pharmacol 2022; 13:976698. [PMID: 36249738 PMCID: PMC9557187 DOI: 10.3389/fphar.2022.976698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/08/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Aloe vera were frequently reported to reduce the risk of radiation-induced dermatitis (RID), but the quantitative results from all the relevant studies were not presently available. This study sought to conduct a cumulative analysis to better clarify the preventive effects of aloe vera in RID. Methods: MEDLINE (PubMed), Cochrane, EMBASE, PsychINFO, Web of Science, China National Knowledge Infrastructure (CNKI), and Wan Fang Database were utilized for identifying the eligible randomized controlled trials (RCTs) without language restrictions, up to March 2022. The pooled incidence of RID was conducted by the Relative risk (RR) with its 95% confidence interval (CI) through the STATA software under a random-effects model. This systematic review and cumulative analysis were registered on PROSPERO (ID: CRD42022335188). Results: Fourteen RCTs met our predefined inclusion criteria, enrolling 1,572 participants (mean age: 46.5–56 years). The cumulative results revealed that patients pretreated with aloe vera were associated with a significantly lower risk of RID compared to those without aloe vera usage (RR = 0.76, 95% CI: 0.67–0.88, p < 0.001; heterogeneity: I2 = 79.8%, p < 0.001). In the subgroup analysis, the pooled incidence of Grade 2–4, Grade 2, and Grade 3 RID was also dramatically lower in the group of aloe vera as compared to the placebo group [RR = 0.44 (0.27, 0.74), 0.58 (0.36, 0.94), and 0.27 (0.12, 0.59) in Grade 2–4, Grade 2, and Grade 3, respectively]. However, in regard to Grade 4 RID, the combined RR indicated that the incidence of RID was comparable between aloe vera and the control group (RR = 0.13, 95% CI: 0.02–1.01, p = 0.051; heterogeneity: I2 = 0.0%, p = 0.741). The sensitivity analyses showed that there was no substantial change in the new pooled RR after eliminating anyone of the included study. Conclusion: The current cumulative analysis revealed that patients pretreated with aloe vera were less likely to suffer from RID than the controls without using aloe vera. Based on this finding, the prophylactic application of aloe vera might significantly reduce the incidence of RID, especially in Grade 2 and Grade 3 RID. Further large-sample multicenter RCTs are still warranted to confirm these findings and for better clinical application.
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Affiliation(s)
- Tingting Wang
- Department of Integrated Traditional Chinese and Western Medicine, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China
| | - Jian Liao
- Department of Nephrology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, Zhejiang, China
| | - Liying Zheng
- Postgraduate Department, First Affiliated Hospital of Gannan Medical College, Ganzhou, China
| | - Yi Zhou
- The 2nd Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Qianru Jin
- Second School of Clinical Medicine, Wenzhou Medical University, Wenzhou, China
| | - Yanjing Wu
- Department of Skin & Cosmetic, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hanzhou, Zhejiang, China
- *Correspondence: Yanjing Wu,
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Tungkasamit T, Chakrabandhu S, Samakgarn V, Kunawongkrit N, Jirawatwarakul N, Chumachote A, Chitapanarux I. Reduction in severity of radiation-induced dermatitis in head and neck cancer patients treated with topical aloe vera gel: A randomized multicenter double-blind placebo-controlled trial. Eur J Oncol Nurs 2022; 59:102164. [DOI: 10.1016/j.ejon.2022.102164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 05/22/2022] [Accepted: 06/11/2022] [Indexed: 11/29/2022]
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Plant and Herbal Extracts as Ingredients of Topical Agents in the Prevention and Treatment Radiodermatitis: A Systematic Literature Review. COSMETICS 2022. [DOI: 10.3390/cosmetics9030063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background: The use of herbal extracts as the source of antioxidant substances capable of neutralizing free radicals and providing protection from ionizing radiation appears to be an alternative therapy for radiodermatitis. As concerns the prevention and treatment of side effects, a lot of recommendations are based on proper experience of radiotherapy centers. We summarize recent research aiming at reducing radiation-induced skin injuries by use of proper skin care, using topical preparations with herbal extracts including onco-cosmetics. Methods: This article is limited to a critical analysis of scientific and professional literature. It concerns preparations in different physicochemical forms, e.g., gels, emulsions, ointments. We stress the connection between the type of applied skin care (type of preparation, its composition, the dose), the properties of the herbal extract and the evaluation of its efficiency in preventing and treating radiation reaction on skin. Conclusions: Herbal extracts can be added to recipes because they are part of a category of cosmeceutical supplements and can be introduced into preparations without prescription. The effectiveness evaluation for herbal extracts in radiotherapy is not an easy task since there are no strict guidelines. Studies should be preceded by the analysis of herbal extracts and recipe in terms of physicochemical, dermatological and performance characteristics.
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Andrade DMO, Camargos MGD, Contim D, Pereira GDA. Uso de Cremes de Camomila e Calêndula na Prevenção de Radiodermatites Agudas em Pacientes com Câncer de Cabeça e Pescoço: Ensaio Clínico Randomizado Duplo-Cego. REVISTA BRASILEIRA DE CANCEROLOGIA 2022. [DOI: 10.32635/2176-9745.rbc.2022v68n2.1963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Introdução: A radiodermatite e caracterizada por lesões cutâneas decorrentes da exposição a radiação ionizante, acometendo entre 80%-90% dos pacientes submetidos a radioterapia na região da cabeça e pescoço. Objetivo: Avaliar a efetividade do uso do creme de camomila em relação ao creme de calêndula na prevenção da radiodermatite aguda em participantes submetidos a radioterapia para câncer de cabeça e pescoço. Método: Ensaio clinico randomizado, duplo-cego, prospectivo, com análise quantitativa. Foram avaliados 23 participantes, aleatoriamente designados para o grupo que fez uso do creme de camomila (n=12) ou para o grupo do creme de calêndula (n=11). A pele no campo de irradiação foi avaliada na primeira sessão de radioterapia, a cada cinco sessoes, e após 30 dias do termino do tratamento, de acordo com os critérios da Radiation Therapy Oncology Group (RTOG). Resultados: Os participantes apresentaram radiodermatite em todas as avaliações, do grau 1 ao 3, exceto na primeira avaliação. O nível médio mais elevado foi observado, em ambos os grupos, na sexta avaliação (2,10±0,73 no grupo do creme de camomila e 2,37±0,51 no de calêndula). No grupo camomila, o maior grau de radiodermatite foi o 3, na quinta e sexta avaliações; enquanto, no calêndula, o grau 3 foi observado pela primeira vez na sexta avaliação, permanecendo até a oitava. Não houve diferença estatisticamente significativa nos grupos avaliados. Conclusão: Houve equivalência na efetividade do uso do creme de camomila em relação ao creme calêndula na prevenção de radiodermatites agudas em pacientes com câncer de cabeça e pescoço em radioterapia.
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Kao YS, Ma KSK, Wu MY, Wu YC, Tu YK, Hung CH. Topical Prevention of Radiation Dermatitis in Head and Neck Cancer Patients: A Network Meta-analysis. In Vivo 2022; 36:1453-1460. [PMID: 35478163 PMCID: PMC9087072 DOI: 10.21873/invivo.12851] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND/AIM Head and neck cancer is a major malignancy worldwide. The treatment strategy for head and neck cancer usually involves radiotherapy. The main side effect of radiotherapy is radiation dermatitis. Thus, determining the most effective topical regimen for the prevention of radiation dermatitis in head and neck cancer patients is a critical issue. PATIENTS AND METHODS PRISMA-NMA guidelines were used in this network meta-analysis. We included only randomized control trials. A random effects model was used. Heterogeneity was evaluated by I2 and Cochran's Q tests. RESULTS We included a total of 1,304 patients in the network meta-analysis. Among them, olive oil was the only effective regimen when compared with usual care (OR=0.18, 95%CI=0.03-0.95). The I2 value was 56%. The test of heterogeneity yielded a p-value of 0.10. CONCLUSION Olive oil was the most effective regimen for the prevention of radiation dermatitis.
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Affiliation(s)
- Yung-Shuo Kao
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Kevin Sheng-Kai Ma
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, U.S.A
- Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan, R.O.C
- Department of Dentistry, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Min-You Wu
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C
| | - Yao-Cheng Wu
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, R.O.C
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan, R.O.C
- School of Dentistry, National Taiwan University, Taipei, Taiwan, R.O.C
| | - Cheng-Hsien Hung
- Department of Pharmacy, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan, R.O.C.
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Muecke R, Gosenheimer R, Schulz C, Heim G, Schmitz V, Harvey C, Zosel-DeIturri A, Nissen A, Hemberger U, Romeis V, Lochhas G, Metzmann U, Bussmann M, Paschold M. Counseling on Complementary Methods in the Treatment of Side Effects of Oncological Therapies: A Project of the Breast and Bowel Center Nahe at the Hospital Sankt Marienwoerth Bad Kreuznach. Integr Cancer Ther 2021; 20:15347354211043199. [PMID: 34581221 PMCID: PMC8481747 DOI: 10.1177/15347354211043199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Increasingly, patients with cancer are asking for additional, complementary therapy options for treating the side effects of oncological therapy. Thus, the members of the Breast and Bowel Center Nahe at the Sankt Marienwörth Hospital Bad Kreuznach decided to define the content of this type of counseling for patients before treatment. METHODS In 2018, a team of internal oncologists, gynecological oncologists, radio-oncologists, nutritionists, psycho-oncologists, and study nurses met several times to define the content of counseling. To inform the team, an intensive literature review was conducted. RESULTS Counseling content was determined for complementary treatment options for the most frequent side effects of oncological therapies. Counseling sessions were formulated as frontal lectures (slide presentations), given at regular intervals for patients and relatives. These lectures were highly appreciated by patients. CONCLUSION These counseling sessions increased patient understanding of both useful complementary measures and harmful measures they should not use.
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Affiliation(s)
- Ralph Muecke
- Mainz-Ruesselsheim-Bad Kreuznach, Bad Kreuznach, Germany.,Ruhr University Bochum, Bochum, Germany.,German Cancer Society, Berlin, Germany
| | | | | | - Gabor Heim
- Hospital Sankt Marienwoerth, Bad Kreuznach, Germany
| | | | | | | | | | | | | | | | - Ute Metzmann
- Mainz-Ruesselsheim-Bad Kreuznach, Bad Kreuznach, Germany
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A randomized, double-blind, placebo-controlled trial of a commercial Aloe vera gel for mitigation of phototherapy side-effects in vitiligo patients. J Herb Med 2021. [DOI: 10.1016/j.hermed.2021.100442] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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10
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Alkhouli M, Laflouf M, Comisi JC. Assessing the topical application efficiency of two biological agents in managing chemotherapy-induced oral mucositis in children: A randomized clinical trial. J Oral Biol Craniofac Res 2021; 11:373-378. [PMID: 33996432 DOI: 10.1016/j.jobcr.2021.04.001] [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] [Received: 01/03/2021] [Revised: 03/12/2021] [Accepted: 04/06/2021] [Indexed: 11/18/2022] Open
Abstract
Background oral mucositis is one of the most annoying complications of chemotherapy. This randomized clinical trial aimed to assess the efficiency of Aloe Vera and Olive Oil in managing chemotherapy-induced oral mucositis. Methods 36 children between 6 and 9 years and suffering from grade 3 or 4 oral mucositis, according to the World Health Organization (W.H.O.) scale, were enrolled in this clinical trial. Participants were separated into three groups to treat their mucositis using Aloe Vera, Olive Oil, or sodium bicarbonate. Nurses administrated the agents four times daily with sponge sticks. Two blinded investigators examined the oral mucosa after ten days. Results Both Aloe Vera and Olive Oil significant differences in the management of chemotherapy-induced oral mucositis compared to sodium bicarbonate treatments. Conclusions Olive Oil is effective in managing CIOM.
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Affiliation(s)
- Muaaz Alkhouli
- Department of Pediatric Dentistry, Faculty of Dentistry, Damascus University, PO Box 30621, Damascus, Syria
| | - Mohannad Laflouf
- Department of Pediatric Dentistry, Faculty of Dentistry, Damascus University, PO Box 30621, Damascus, Syria
| | - John C Comisi
- Department of Oral Rehabilitation, Medical University of South Carolina, James B. Edwards College of Dental Medicine, 173 Ashley Ave, BSB 548, MSC 507, Charleston, SC, 29425, USA
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Koukourakis G, Pissakas G, Ganos CG, Sivolapenko G, Kardamakis D. Effectiveness and Tolerability of Natural Herbal Formulations in the Prevention of Radiation-Induced Skin Toxicity in Patients Undergoing Radiotherapy. INT J LOW EXTR WOUND 2020; 21:75-86. [PMID: 32525718 DOI: 10.1177/1534734620923912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study is to investigate the preventive role of 3 herbal formulation products on reducing the incidence of radiation-induced dermatitis in patients undergoing radiotherapy for either breast or head and neck cancer. A total of 59 patients participated in the study. The novel herbal products, a combination of beeswax, olive oil, Calendula and Hypericum oils and Aloe gel, were daily and regularly being used by the patients during radiotherapy and 2 weeks after treatment end. Acute skin toxicity was scored weekly during radiotherapy and after treatment for a further 4-week follow-up period. Demographic data were analyzed by descriptive statistics. Statistical analyses of the study objectives were based on an intent-to-treat principle. Most of the patients presented with grade I (RTOG/EORTC) toxicity in the first weeks of radiotherapy, progressed to grade II but reverted to grade I toxicity up until the study end. A total of 94.9% of the patients had Dermatology Life Quality Index up to 1, and 66.1% remained in this scale. The application of the novel natural product combinations proved to be statistically significantly effective in reducing the intensity of radiation dermatitis, positively affecting the quality of life of the patients.
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Svitina H, Swanepoel R, Rossouw J, Netshimbupfe H, Gouws C, Hamman J. Treatment of Skin Disorders with Aloe Materials. Curr Pharm Des 2020; 25:2208-2240. [PMID: 31269881 DOI: 10.2174/1381612825666190703154244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 06/20/2019] [Indexed: 01/09/2023]
Abstract
The skin is the largest organ and functions as a barrier to protect the underlying tissues against the elements and pathogens, while also fulfilling many physiological roles and biochemical functions such as preventing excessive water loss. Skin disorders vary greatly in terms of origin, severity, symptoms and affect persons of all ages. Many plants have been used for medicinal purposes since ancient times including the treatment of skin disorders and diseases. Aloe represents one of the earliest medicinal plant species mentioned in antique scriptures and even in rock art dating back thousands of years. Different Aloe species and materials have been used in the prevention and treatment of skin related disorders. Aloe vera is the most commonly used Aloe species for medicinal purposes. Some of the most prominent skin related applications and disorders that Aloe materials have been investigated for are discussed in this paper, which include cosmetic, radiation, cancer, wound and antimicrobial applications. Both in vitro and in vivo studies are included in the discussions of this paper and comprehensive summaries of all these studies are given in tables in each section. Although some contradictory results were obtained among studies, certain Aloe materials have shown excellent efficacy and exhibited potential for the treatment of skin related disorders and cosmetic applications.
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Affiliation(s)
- Hanna Svitina
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Roan Swanepoel
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Jacques Rossouw
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Happiness Netshimbupfe
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Chrisna Gouws
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Josias Hamman
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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Jaiswal I, Talapatra K, Singh P, Rais S, Pandey S. Radiation dermatitis: A narrative review of the Indian perspective. CANCER RESEARCH, STATISTICS, AND TREATMENT 2020. [DOI: 10.4103/crst.crst_209_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Davis SC, Simpson J, Gil-Vega KDC, Niechayev NA, van Tongerlo E, Castano NH, Dever LV, Búrquez A. Undervalued potential of crassulacean acid metabolism for current and future agricultural production. JOURNAL OF EXPERIMENTAL BOTANY 2019; 70:6521-6537. [PMID: 31087091 PMCID: PMC6883259 DOI: 10.1093/jxb/erz223] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 05/03/2019] [Indexed: 05/11/2023]
Abstract
The potential for crassulacean acid metabolism (CAM) to support resilient crops that meet demands for food, fiber, fuel, and pharmaceutical products far exceeds current production levels. This review provides background on five families of plants that express CAM, including examples of many species within these families that have potential agricultural uses. We summarize traditional uses, current developments, management practices, environmental tolerance ranges, and economic values of CAM species with potential commercial applications. The primary benefit of CAM in agriculture is high water use efficiency that allows for reliable crop yields even in drought conditions. Agave species, for example, grow in arid conditions and have been exploited for agricultural products in North and South America for centuries. Yet, there has been very little investment in agricultural improvement for most useful Agave varieties. Other CAM species that are already traded globally include Ananas comosus (pineapple), Aloe spp., Vanilla spp., and Opuntia spp., but there are far more with agronomic uses that are less well known and not yet developed commercially. Recent advances in technology and genomic resources provide tools to understand and realize the tremendous potential for using CAM crops to produce climate-resilient agricultural commodities in the future.
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Affiliation(s)
- Sarah C Davis
- Voinovich School of Leadership and Public Affairs, Ohio University, Athens, OH, USA
- Department of Environmental and Plant Biology, Ohio University, Athens, OH, USA
| | - June Simpson
- Department of Genetic Engineering, Cinvestav Unidad Irapuato, Irapuato, Guanajuato, México
| | | | - Nicholas A Niechayev
- Department of Biochemistry and Molecular Biology, University of Nevada, Reno, NV, USA
| | - Evelien van Tongerlo
- Horticulture and Product Physiology, Wageningen University, Wageningen, The Netherlands
| | | | - Louisa V Dever
- Department of Functional and Comparative Genomics, Institute of Integrative Biology, University of Liverpool, Liverpool, UK
| | - Alberto Búrquez
- Instituto de Ecología, Universidad Nacional Autónoma de México, Unidad Hermosillo, Sonora, México
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15
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Ryan Wolf J, Gewandter JS, Bautista J, Heckler CE, Strasser J, Dyk P, Anderson T, Gross H, Speer T, Dolohanty L, Bylund K, Pentland AP, Morrow GR. Utility of topical agents for radiation dermatitis and pain: a randomized clinical trial. Support Care Cancer 2019; 28:3303-3311. [PMID: 31758326 DOI: 10.1007/s00520-019-05166-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 10/31/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE Although topical agents are often provided during radiation therapy, there is limited consensus and evidence for their use prophylactically to prevent or reduce radiation dermatitis. METHODS This was a multi-site, randomized, placebo-controlled, blinded study of 191 breast cancer patients to compare the prophylactic effectiveness of three topical agents (Curcumin, HPR Plus™, and Placebo) for reducing radiation dermatitis and associated pain. Patients applied the topical agent to their skin in the radiation area site three times daily starting the first day of radiation therapy (RT) until 1 week after RT completion. RESULTS Of the 191 randomized patients, 171 patients were included in the final analyses (87.5% white females, mean age = 58 (range = 36-88)). Mean radiation dermatitis severity (RDS) scores did not significantly differ between study arms (Curcumin = 2.68 [2.49, 2.86]; HPR Plus™ = 2.64 [2.45, 2.82]; Placebo = 2.63 [2.44, 2.83]; p = 0.929). Logistic regression analyses showed that increased breast field separation positively correlated with increased radiation dermatitis severity (p = 0.018). In patients with high breast field separation (≥ 25 cm), RDS scores (Curcumin = 2.70 [2.21, 3.19]; HPR Plus™ = 3.57 [3.16, 4.00]; Placebo = 2.95 [2.60, 3.30]; p = 0.024) and pain scores (Curcumin = 0.52 [- 0.28, 1.33]; HPR Plus™ = 0.55 [- 0.19, 1.30]; Placebo = 1.73 [0.97, 2.50]; p = 0.046) significantly differed at the end of RT. CONCLUSIONS Although there were no significant effects of the treatment groups on the overall population, our exploratory subgroup analysis suggests that prophylactic treatment with topical curcumin may be effective for minimizing skin reactions and pain for patients with high breast separation (≥ 25 cm) who may have the worst skin reactions.
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Affiliation(s)
- Julie Ryan Wolf
- Department of Dermatology, University of Rochester Medical Center, 601 Elmwood Ave, Box 697, Rochester, NY, 14642, USA.
| | - Jennifer S Gewandter
- Department of Anesthesiology, University of Rochester Medical Center, Rochester, NY, USA
| | - Javier Bautista
- URCC NCORP Research Base, University of Rochester Medical Center, Rochester, NY, USA
| | - Charles E Heckler
- URCC NCORP Research Base, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Pawal Dyk
- Heartland Cancer Research NCORP, St. Louis, MO, USA
| | | | - Howard Gross
- Dayton Clinical Oncology Program, Dayton, OH, USA
| | - Tod Speer
- Metro-Minnesota NCORP, St. Louis Park, MN, USA
| | - Lindsey Dolohanty
- Department of Dermatology, University of Rochester Medical Center, 601 Elmwood Ave, Box 697, Rochester, NY, 14642, USA
| | - Kevin Bylund
- Department Radiation Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - Alice P Pentland
- Department of Dermatology, University of Rochester Medical Center, 601 Elmwood Ave, Box 697, Rochester, NY, 14642, USA
| | - Gary R Morrow
- URCC NCORP Research Base, University of Rochester Medical Center, Rochester, NY, USA
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16
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Abstract
Palliative wound care is a philosophy of wound management that prioritizes comfort over healing and attends to the emotional distress these wounds can cause. Intervention strategies focus on management of symptoms such as pain, odor, bleeding, and exudate. Historic treatments such as honey, chlorine, and vinegar have gained renewed interest, and although well suited to the palliative setting, there is an increasing amount of research exploring their efficacy in other contexts. The lived experience of patients and caregivers facing these wounds is often stressful and isolating, and any treatment plan must address these issues along with the physical aspects of care.
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17
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Chou HL, Shueng PW, Liao LJ, Hsu CX, Kuo DY, Lo WC, Hou PY, Wang LY, Chou SF, Hsieh CH. Prophylactic NS-21 maintains the skin moisture but does not reduce the severity of radiation dermatitis in patients with head and neck cancer: a randomized control trial. Radiat Oncol 2019; 14:90. [PMID: 31146741 PMCID: PMC6543645 DOI: 10.1186/s13014-019-1302-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 05/22/2019] [Indexed: 12/22/2022] Open
Abstract
Background To evaluate the practicality of NS-21 cream with regard to its skin-related toxicity in patients with head and neck cancer (HNC) who are undergoing concurrent chemoradiation therapy (CCRT) or radiotherapy (RT). Methods Between July 2015 and November 2017, 30 HNC patients who underwent RT or CCRT were randomly allocated to receive either NS-21 or control treatment on their irradiated skin three times per day, starting at the initiation of RT or CCRT and ending 2 weeks after the completion of RT or until the appearance of grade 3 acute radiation dermatitis (ARD). Dermatitis was recorded weekly according to the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Skin humidity was monitored by a digital moisture meter. The generalized estimating equation (GEE) and logit link function method were used for statistical analysis. Results No serious adverse events were observed in either group. Itching dermatitis occurred on the right lower neck in one patient of the NS-21 group during the 3rd week of CCRT, but the severity was mild. The median skin moisture value at the time of the final treatment was significantly different between the study and control groups (30.6 vs. 27.3, p = 0.013). Additionally, there was an inverse relationship between skin moisture and ARD grade (B = -0.04, p = 0.005). The incidence of ARD at the time of the last treatment was not significantly different between the study and control groups (6.7% vs 26.7%, p = 0.165). The risk of grade 3 ARD for skin that had received an irradiation dose of 47–70 Gy was higher than that of skin that had received an irradiation dose ≤46 Gy (OR = 31.06, 95% CI =5.95–162.21, p < 0.001). Nevertheless, the risk of ARD was not significantly different between the groups (OR = 0.38, 95% CI = 0.08–1.74, p = 0.212). Conclusions NS-21 was well tolerated and effective for the maintenance of skin moisture; however, there was no statistically significant reduction in the risk of ARD in HNC patients undergoing RT or CCRT when compared with HNC patients in the control group. Trial registration The study was approved by the Institutional Review Board of Far Eastern Memorial Hospital (FEMH-IRB, 104048-F), Registered 1st June 2015,
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Affiliation(s)
- Hsiu-Ling Chou
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,School of Nursing, National Yang-Ming University, Taipei, Taiwan.,Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan
| | - Pei-Wei Shueng
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, 21 Sec 2, Nanya S Road, Banciao District, New Taipei City, 220, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan.,Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
| | - Chen-Xiong Hsu
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, 21 Sec 2, Nanya S Road, Banciao District, New Taipei City, 220, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Deng-Yu Kuo
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, 21 Sec 2, Nanya S Road, Banciao District, New Taipei City, 220, Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Pei-Yu Hou
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, 21 Sec 2, Nanya S Road, Banciao District, New Taipei City, 220, Taiwan
| | - Li-Ying Wang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
| | - San-Fang Chou
- Department of Medical Research, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chen-Hsi Hsieh
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, 21 Sec 2, Nanya S Road, Banciao District, New Taipei City, 220, Taiwan. .,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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18
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Soriano JL, Calpena AC, Souto EB, Clares B. Therapy for prevention and treatment of skin ionizing radiation damage: a review. Int J Radiat Biol 2019; 95:537-553. [DOI: 10.1080/09553002.2019.1562254] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- José L. Soriano
- Department of Pharmacy and Pharmaceutical Technology Faculty of Pharmacy, University of Granada, Granada, Spain
| | - Ana C. Calpena
- Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Nanoscience and Nanotechnology Institute (IN2UB), University of Barcelona, Barcelona, Spain
| | - Eliana B. Souto
- Department of Pharmaceutical Technology Faculty of Pharmacy, University of Coimbra (FFUC), Pólo das Ciências da Saúde, Azinhaga de Santa Comba, Coimbra, Portugal
- CEB - Centre of Biological Engineering, University of Minho, Braga, Portugal
| | - Beatriz Clares
- Department of Pharmacy and Pharmaceutical Technology Faculty of Pharmacy, University of Granada, Granada, Spain
- Nanoscience and Nanotechnology Institute (IN2UB), University of Barcelona, Barcelona, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), SAS-University of Granada, Granada, Spain
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