Hostname: page-component-76fb5796d-skm99 Total loading time: 0 Render date: 2024-04-25T12:17:34.388Z Has data issue: false hasContentIssue false

Role of turmeric extract in minimising mucositis in patients receiving radiotherapy for head and neck squamous cell cancer: a randomised, placebo-controlled trial

Published online by Cambridge University Press:  07 February 2020

P Arun*
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Government Medical College, Palakkad, India
A Sagayaraj
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Sri Devaraj Urs Medical College, Kolar, India
S M Azeem Mohiyuddin
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Sri Devaraj Urs Medical College, Kolar, India
D Santosh
Affiliation:
Department of Radiotherapy, Sri Devaraj Urs Medical College, Kolar, India
*
Author for correspondence: Dr P Arun, Department of Otolaryngology and Head and Neck Surgery, Government Medical College, Palakkad, Kerala, India E-mail: gmc.drarun@gmail.com

Abstract

Objective

To determine the role of turmeric extract in reducing mucositis in patients undergoing radiotherapy for head and neck cancer.

Methods

Sixty-one patients who underwent radiotherapy were included in the study and randomised into groups A and B. Patients in group A received 500 mg of turmeric extract (BCM-95) thrice daily, while patients in group B received placebo until radiotherapy completion. All patients were assessed for oral mucositis on a weekly basis during treatment and two months post-treatment using the National Cancer Institute Common Terminology Criteria for Adverse Events and World Health Organization criteria.

Results

Both groups had a similar grade of mucositis in first two weeks of treatment. The severity of mucositis was progressive in the control group, with four patients developing grade 3 mucositis by week four. In group A, however, the majority of patients (73.3 per cent) had grade 1 mucositis after four weeks of treatment. The difference was statistically significant from the third week onwards (p < 0.001).

Conclusion

Turmeric extract reduces the incidence and severity of radiation-induced mucositis, which can benefit patients undergoing radiation for head and neck cancer.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited, 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr P Arun takes responsibility for the integrity of the content of the paper

References

Ferlay, J, Soerjomataram, I, Ervik, M, Dikshit, R, Eser, S, Mathers, C et al. GLOBOCAN 2012 v1.0. Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. Lyon: International Agency for Research on Cancer, 2013Google Scholar
Hennequin, C, Favaudon, V. Biological basis for chemo-radiotherapy interactions. Eur J Cancer 2002;38:223–30CrossRefGoogle ScholarPubMed
Gupta, T, Agarwal, JP, Ghosh-Laskar, S, Parikh, PM, D'Cruz, AK, Dinshaw, KA. Radical radiotherapy with concurrent weekly cisplatin in loco-regionally advanced squamous cell carcinoma of the head and neck: a single-institution experience. Head Neck Oncol 2009;1:17CrossRefGoogle ScholarPubMed
Maria, OM, Eliopoulos, N, Muanza, T. Radiation-induced oral mucositis. Front Oncol 2017;7:89CrossRefGoogle ScholarPubMed
Benny, M, Antony, B. Bioavailability of Biocurcumax™ (BCM-095™). Spice India 2006;1115Google Scholar
Antony, B, Benny, M, Rao, SB. Enhancing the absorption of curcuminoids. Spice India 2005;23–6Google Scholar
Maheshwari, M. Comparative bioavailability of curcumin, turmeric and Biocurcumax™ in traditional vehicles using non-everted rat intestinal sac model. J Funct Foods 2010;2:60–5Google Scholar
Aggarwal, ML, Chacko, KM, Kuruvilla, BT. Systematic and comprehensive investigation of the toxicity of curcuminoid – essential oil complex: a bioavailable turmeric formulation. Mol Med Rep 2016;13:592604CrossRefGoogle Scholar
Vinaykumar, S, Rathnakar, UP, Dinkar, US, Priyanka, K, Gaurav, T, Kudgi, SA et al. Anti-inflammatory activity of BCM-95 (bio-enhanced formulation of turmeric with increased bioavailability) compared to curcumin in Wistar rats. Pharmacogn J 2016;8:380–4CrossRefGoogle Scholar
Sonis, ST, Elting, LS, Keefe, D, Peterson, DE, Schubert, M, Hauer-Jensen, M. Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer 2004;100:19952025CrossRefGoogle ScholarPubMed
Wilken, R, Veena, MS, Wang, MB, Srivatsan, ES. Curcumin: a review of anti-cancer properties and therapeutic activity in head and neck squamous cell carcinoma. Mol Cancer 2011;10:12CrossRefGoogle ScholarPubMed
Aggarwal, BB, Surh, YJ, Shishodia, S. The molecular targets and therapeutic uses of curcumin in health and disease. Advances in experimental medicine and biology. 2007;595:159–61Google Scholar
Jurenka, JS. Anti-inflammatory properties of curcumin, a major constituent of Curcuma longa: a review of preclinical and clinical research. Altern Med Rev 2009;14:141–53Google Scholar
Deodhar, SD, Sethi, R, Srimal, RC. Preliminary study on anti-rheumatic activity of curcumin (diferuloyl methane). Indian J Med Res 1980;71:632–4Google Scholar
Kulkarni, RR, Patki, PS, Jog, VP, Gandage, SG, Patwardhan, B. Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo controlled, cross-over study. J Ethnopharmacol 1991;33:91–5CrossRefGoogle ScholarPubMed
Rao, S, Dinkar, C, Vaishnav, LK, Rao, P, Rai, MP, Fayad, R et al. The Indian spice turmeric delays and mitigates radiation-induced oral mucositis in patients undergoing treatment for head and neck cancer: an investigational study. Integr Cancer Ther 2013;13:201–10CrossRefGoogle Scholar
Lüer, SC, Goette, J, Troller, R, Aebi, C. Synthetic versus natural curcumin: bioequivalence in an in vitro oral mucositis model. BMC Complement Altern Med 2014;14:53CrossRefGoogle Scholar
Burgos-Moron, E, Calderon-Montano, JM, Salvador, J, Robles, A, Lopez-Lazaro, M. The dark side of curcumin. Int J Cancer 2010;126:1771–5Google ScholarPubMed
Nelson, KM, Dahlin, JL, Bisson, J, Graham, J, Pauli, GF, Walters, MA. The essential medicinal chemistry of curcumin: mini perspective. J Med Chem 2017;60:1620–37CrossRefGoogle Scholar
Antony, B, Merina, B, Iyer, VS, Judy, N, Lennertz, K, Joyal, S. A pilot cross-over study to evaluate human oral bioavailability of BCM-95 CG (Biocurcumax), a novel bioenhanced preparation of curcumin. Indian J Pharm Sci 2008;70:445–9CrossRefGoogle Scholar
Yue, GG, Cheng, SW, Yu, H, Xu, ZS, Lee, JK, Hon, PM et al. The role of turmerones on curcumin transportation and P-glycoprotein activities in intestinal Caco-2 cells. J Med Food 2012;15:242–52CrossRefGoogle ScholarPubMed
Murakami, A, Furukawa, I, Miyamoto, S, Tanaka, T, Ohigashi, H. Curcumin combined with turmerones, essential oil components of turmeric, abolishes inflammation-associated mouse colon carcinogenesis. Biofactors 2013;39:221–32CrossRefGoogle ScholarPubMed
Toden, S, Theiss, AL, Wang, X, Goel, A. Essential turmeric oils enhance anti-inflammatory efficacy of curcumin in dextran sulfate sodium-induced colitis. Sci Rep 2017;7:814CrossRefGoogle ScholarPubMed
Leray, V, Freuchet, B, Le Bloch, J, Jeusette, I, Torre, C, Nguyen, P. Effect of citrus polyphenol- and curcumin-supplemented diet on inflammatory state in obese cats. Br J Nutr 2011;106:S198201CrossRefGoogle Scholar
Durgaprasad, S, Reetesh, R, Hareesh, K, Rajput, R. Effect of a topical curcumin preparation (BIOCURCUMAX) on burn wound healing in rats. J Pharm Biomed Res 2011;8:13Google Scholar
Siddappa, G, Kulsum, S, Ravindra, DR, Kumar, VV, Raju, N, Raghavan, N et al. Curcumin and metformin-mediated chemoprevention of oral cancer is associated with inhibition of cancer stem cells. Mol Carcinog 2017;56:2446–60CrossRefGoogle ScholarPubMed
Hejazi, J, Rastmanesh, R, Taleban, FA, Molana, SH, Ehtejab, G. A pilot clinical trial of radioprotective effects of curcumin supplementation in patients with prostate cancer. J Cancer Sci Ther 2013;5:320–4Google Scholar
Hejazi, J, Rastmanesh, R, Taleban, FA, Molana, SH, Hejazi, E, Ehtejab, G et al. Effect of curcumin supplementation during radiotherapy on oxidative status of patients with prostate cancer: a double blinded, randomised, placebo-controlled study. Nutr Cancer 2016;68:7785CrossRefGoogle Scholar