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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 ,
A Sagayaraj ,
S M Azeem Mohiyuddin  and
D Santosh
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: [email protected]
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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.

Keywords

TurmericMucositisHead And Neck Squamous Cell CarcinomaRadiationChemoradiotherapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 2 , February 2020 , pp. 159 - 164
Copyright
Copyright © JLO (1984) Limited, 2020

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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;11–15Google 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;13:592–604CrossRefGoogle 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;100:1995–2025CrossRefGoogle 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:S198–201CrossRefGoogle 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;8:1–3Google 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;68:77–85CrossRefGoogle Scholar