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Guan Y, Liu S, Li A, Cheng W. Comparison of the efficacy among different interventions for radiodermatitis: A Bayesian network meta‑analysis of randomized controlled trials. PLoS One 2024; 19:e0298209. [PMID: 38598529 PMCID: PMC11006171 DOI: 10.1371/journal.pone.0298209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/20/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Radiation dermatitis (RD) is a prevalent and difficult-to-manage consequence of radiation therapy (RT). A variety of interventions have been proven effective in preventing and treating RD. However, the optimal approach remains unclear. This network meta-analysis (NMA) conducted a comparison and ranking of the effectiveness and patient-reported outcomes (PROs) of the interventions currently utilized in RD. METHODS PubMed, Web of Science, Embase, and Cochrane Library were searched to identify pertinent randomized controlled trials (RCTs) focused on the prevention and treatment of RD. The primary outcome measures included the incidence of grade≥2 RD (i.e., percentage of moist desquamation) and RD score. The secondary outcome measures encompassed patients' subjective assessment scores of pains, itching and burning sensations. RESULTS Our meta-analysis encompassed 42 studies and 4884 participants. Regarding the primary outcomes, photobiomodulation treatment (PBMT) ranked first in surface under curve cumulative ranking area (SUCRA:0.92) for reducing the incidence of grade≥2 RD. It demonstrated a significant difference when compared to Trolamine (OR 0.18,95%CrI 0.09-0.33) and Xonrid® (OR 0.28,95%CrI 0.12-0.66). Mepitelfilm (SUCRA: 0.98) achieved the highest rank in reducing the RD score, demonstrating superiority over StrataXRT® (MD -0.89, 95% CrI -1.49, -0.29). Henna (SUCRA: 0.89) demonstrated the highest effectiveness in providing pain relief, with a significant difference compared to Hydrofilm (MD -0.44, 95% CrI -0.84, -0.04) and Mepitelfilm (MD -0.55, 95% CrI -0.91, -0.19). Hydrofilm (SUCRA: 0.84) exhibited the fewest itching sensations, demonstrating superiority over Mepitelfilm (MD -0.50, 95% CrI -0.84, -0.17). No statistically significant difference was observed among various interventions in the assessment of burning sensations. CONCLUSION PBMT and Mepitelfilm demonstrated better efficacy in reducing the incidence of grade≥2 RD and RD score, respectively. In terms of PROs, Henna and Hydrofilm had fewer complaints in pain and itching sensations, respectively. However, studies with larger sample size on different interventions are warranted in the future. TRIAL REGISTRATION PROSPERO registration number CRD42023428598.
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Affiliation(s)
- Ying Guan
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, P.R. China
| | - Shuai Liu
- Department of Radiotherapy Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, P. R. China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, P. R. China
| | - Anchuan Li
- Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou, P. R. China
| | - Wanqin Cheng
- Department of Radiation Oncology, Shunde Hospital, Southern Medical University, Shunde, P. R. China
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Ramos Rocha S, da Costa Ferreira SA, Ramalho A, Conceição Gouveia Santos VL, Cristina Nogueira P. Photobiomodulation Therapy in the Prevention and Treatment of Radiodermatitis in Breast Cancer Patients: Systematic Review. J Lasers Med Sci 2022; 13:e42. [PMID: 36743146 PMCID: PMC9841382 DOI: 10.34172/jlms.2022.42] [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: 12/20/2021] [Accepted: 07/17/2022] [Indexed: 01/27/2023]
Abstract
Introduction: Radiodermatitis (RD) is the most common side-effect of radiation therapy, yet its prevention and treatment through photobiomodulation therapy (PBMT) have demonstrated promising results. This study aimed to synthesize the evidence concerning the use of PBMT in managing RD among breast cancer patients undergoing radiation therapy. Methods: This is a systematic review with no time restrictions, based on the methodology proposed by the Joanna Briggs Institute (JBI), including such databases as PubMed, Cochrane, Web of Science, Scopus, and CINAHL. The studies were selected based on the following inclusion criteria: female participants over 18 years of age and females having breast cancer and undergoing radiation therapy using a three-dimensional technique or an intensity-modulated radiation therapy (IMRT) technique. Two reviewers assessed the methodological quality using the JBI Critical Appraisal Checklist, and the report was described based on PRISMA guidelines. Results: Red and infrared wavelengths were used. Device power ranged from 1.1 W to 0.08 W for continuous modes and 25 W for pulsed mode, resulting in a 3 and 4 J/cm2 fluence, applied throughout radiation therapy, leading to a reduced severity in cutaneous reactions. Conclusion: PBMT can reduce the severity of RD. New clinical trials are required to standardize protocols, given the scarcity of studies for the adopted site and methodological diversity.
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Affiliation(s)
- Suzy Ramos Rocha
- Correspondence to Suzy Ramos Rocha, 14 Bis Square, n 18, apartment 52, Bela Vista, São Paulo, SP, Brazil. CEP 01312-010.
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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 DOI: 10.21873/invivo.12851] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [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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Garbuio DC, Ribeiro VDS, Hamamura AC, Faustino A, Freitas LAPD, Viani G, Carvalho ECD. A Chitosan-Coated Chamomile Microparticles Formulation to Prevent Radiodermatitis in Breast: A Double-blinded, Controlled, Randomized, Phase II Clinical Trial. Am J Clin Oncol 2022; 45:183-189. [PMID: 35393979 DOI: 10.1097/coc.0000000000000905] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim was to evaluate the effect of a topical formulation containing chitosan-coated Chamomilla recutita (L.) rauschert microparticles regarding the incidence, grade, and days for the appearance of radiodermatitis (RD) in women with breast cancer. METHODS A double-blinded, controlled, randomized, phase II clinical trial developed with women diagnosed with breast cancer who will receive radiation therapy. The participants were randomly divided into 2 groups: control and treatment. They were followed up until the end of the treatment or the appearance of grade III RD. RESULTS Fifty-four women were included in the study. There is no significant difference between the groups in the incidence (88.9% vs. 88.9%, P=1.0) or time to develop any grade of RD (3 days of difference, P=0.300). A significant reduction was observed in the incidence (P=0.03) and in the time to appearance (7 d of difference, P=0.01) grade 2 or >RD. In the follow-up evaluation (15 d after the end of treatment), the Chamomile group presented a superior skin recovery than the control group (P=0.0343). High-intensity local symptoms as pain, and pruritus were significantly reduced in the Chamomile group. CONCLUSIONS Although no effect was observed with chamomile to reduce any grade of RD, it was effective to reduce grade 2 or >toxicity, to improve skin recovery and to diminish high-intensity local symptoms. TRIAL REGISTRATION Brazilian Registry of Clinical Trials (ReBEC): RBR-9hnftg, April 29, 2019.
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Affiliation(s)
| | | | | | | | | | - Gustavo Viani
- Ribeirão Preto Medical School, São Paulo University, São Paulo, Brazil
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Kotov S, Gontova T, Kononenko N, Chernyavski E, Chikitkina V. Phytochemical analysis and anti-allergic activity of a combined herbal medicine based on bur-marigold, calendula and hawthorn. PHARMACIA 2022. [DOI: 10.3897/pharmacia.69.e77624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Using an experimentally selected extractant for balanced extraction of flavonoids, polysaccharides and polyphenols from bur-marigold herb, calendula flowers and hawthorn leaves and flowers, 3 suitable dry extracts and 1 combined extract in the selected ratio of raw materials were obtained. It was concluded that it was reasonable to standardize the combined herbal extract on the content of flavonoids in terms of luteolin-7-glucoside and content of polyphenols in terms of pyrogallol by UV method and the content of terpenoid compounds, in terms of oleanolic acid by densitometric method. The combined extract at a dose of 30 mg/kg in the model of anaphylactic shock has showed antiallergic activity at the level of tesalin and exceeds diazoline; the ability of the combined extract to reduce the permeability of skin capillaries at the level of the tesalin has established on the model of active cutaneous anaphylaxis and it significantly exceeded diazoline; the combined extract did not differ in membrane-stabilizing properties from the effect of desloratadine and was significantly superior to the reference drugs diazolin and tesalin in the test of indirect degranulation of mast cells. As a result, it was concluded that the mechanism of anti-allergic action of the combined extract is probably associated not only with antihistamine properties but also with the ability to stabilize cell membranes.
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Alan Z, Özgüldü H, Erdal MS, Bucak AY, Üresin AY, Akalın E. Evaluation of clinical trials of the plants, which have ethnobotanical uses for skin disorders in Turkey: a review. CLINICAL PHYTOSCIENCE 2021. [DOI: 10.1186/s40816-021-00316-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Abstract
Background
Ethnobotanical studies investigating a large number of traditional herbs and uses have an important role in the discovery of new drugs. Nowadays, some of these traditional herbs are researched directly in the clinical trials. In this study, it is aimed to evaluate the 19 plant species that have been identified in the clinical trials among 300 plant species belonging to 79 families with traditional use for skin problems in Turkey.
Main body
Natural sources are very important to treat diseases for thousands of years. The ethnopharmacological research of natural products ranges from the collection of biogenic samples such as plants to preclinical and clinical studies with the aim of developing drug templates or new drugs. In the ethnopharmacological approach, it is aimed to reach the result based on the traditional and modern knowledge about natural resources. The biggest advantage of this approach is synthesizing new and old information. After the plant or natural compound is determined, other processes work similarly with conventional drugs.
Methods
Ethnobotanical papers, thesis and projects in Istanbul University Faculty of Pharmacy Department of Pharmaceutical Botany and databases (PubMed and Google Scholar) have been sought and results were synthesized.
Results
Most of the clinical uses of herbs have been seen similar to their traditional uses. On the other hand, there are some plants on which their clinical uses differ from the traditional uses such as Borago officinalis, Calendula officinalis or Euphorbia peplus. When the frequency of traditional uses of herbs are compared, Plantago species, Plantago major and Plantago lanceolata are the most used taxa in Turkey, secondly, Hypericum perforatum comes. However, Plantago species are not of much interest in clinical trials. It is seen that most of the plants in the clinical research are tried for wound healing occuring due to different origins such as cancer, surgery and injury.
Side effects were observed only during the application of Allium cepa, Cydonia oblonga and H. perforatum.
Conclusions
When clinical trials are evaluated in terms of efficacy and overall results, significant differences and effective results are seen in treatment groups given herbs in comparison with placebo or control groups.
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Heydarirad G, Ahadi B, Molavi Vardanjani H, Cramer H, Mirzaei HR, Pasalar M. Herbal Medicines for Treatment of Radiodermatitis: A Systematic Review and Meta-Analysis. J Altern Complement Med 2021; 27:1098-1104. [PMID: 34449259 DOI: 10.1089/acm.2021.0166] [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] Open
Abstract
Background: There is some evidence in favor of the efficacy of herbal medicine in the treatment of radiodermatitis as a frequent complication among cancer patients. Purpose: The present study aimed to evaluate the effect of herbal medicines on the treatment of radiodermatitis in cancer patients. Study design: Systematic review performed in accordance with the PRISMA guideline. Methods: We searched the electronic databases, Scopus, PubMed, Cochrane Library, Embase, Google Scholar, and ISI Web of Science, through July 2020 for randomized controlled trials (RCTs) that compared herbal compounds against a standard medication or placebo for treatment or prevention of radiodermatitis. Results: A total of 16 RCTs involving 1886 patients with breast, head and neck, or unspecified cancer were included. Risk of bias generally was high. Of those, three RCTs with 562 cancer patients (mainly breast cancer) who used Aloe vera to treat radiodermatitis were included in the meta-analysis. There was a significant level of heterogeneity between the studies (I2 = 95.8). One RCT found positive effects of Aloe vera in reducing the severity of radiodermatitis (standardized mean difference [SMD] = 3.37), whereas another revealed an inverse effect (SMD = -4). Conclusion: At present, there are no herbal compositions that are effective in treating radiodermatitis, with Aloe vera failing to show sufficient efficacy in the meta-analysis.
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Affiliation(s)
- Ghazaleh Heydarirad
- Traditional Medicine and Materia Medica Research Center, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahareh Ahadi
- Department of Persian Medicine, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Hossein Molavi Vardanjani
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Hamid Reza Mirzaei
- Department of Radiation Oncology, Cancer Research Center, Shohadae Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Pasalar
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Kondziołka J, Wilczyński S. Overview of the Active Ingredients in Cosmetic Products for the Care of Skin That Has Been Exposed to Ionizing Radiation - Analysis of Their Effectiveness in Breast Cancer Radiotherapy. Clin Cosmet Investig Dermatol 2021; 14:1065-1076. [PMID: 34471371 PMCID: PMC8405097 DOI: 10.2147/ccid.s322228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 07/16/2021] [Indexed: 01/03/2023]
Abstract
Treatment that uses ionizing radiation is one of the most common therapeutic methods in case of breast cancer. However, it often results in radiation dermatitis, which manifests itself, among others, as erythema, burning, itching and pain as well as dry or moist desquamation of the epidermis in the irradiated areas. The intensity of these symptoms significantly reduces the patient's quality of life, which could affect the effectiveness of the entire therapy. There are more and more cosmetic preparations on the market for daily care of skin that has been exposed to radiation. The composition of the active ingredients in these preparations is designed to support the protective functions of the skin, delay the occurrence of the side effects of ionizing radiation, reduce their intensity, and accelerate the regeneration of the irradiated areas. Unfortunately, there is little scientific evidence of the effectiveness of the active ingredients that are contained in these preparations. This paper presents a narrative review of the most commonly used ingredients and compares them with the current state of knowledge on their effectiveness in preventing radiodermatitis.
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Affiliation(s)
- Joanna Kondziołka
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Sławomir Wilczyński
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
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Ferreira EB, Ciol MA, de Meneses AG, Bontempo PDSM, Hoffman JM, Reis PEDD. Chamomile Gel versus Urea Cream to Prevent Acute Radiation Dermatitis in Head and Neck Cancer Patients: Results from a Preliminary Clinical Trial. Integr Cancer Ther 2021; 19:1534735420962174. [PMID: 32985288 PMCID: PMC7545760 DOI: 10.1177/1534735420962174] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
We assessed safety and potential efficacy of a chamomile gel compared with urea cream to prevent acute radiation dermatitis in head and neck cancer patients. We assessed safety and potential efficacy of the chamomile gel in escalating concentrations of 2.50%, 5.00% and 8.35% of chamomile. Concentration of 8.35% was chosen for a randomized trial comparing chamomile gel (8.35%) with urea cream (n = 24 per group), for potential efficacy to delay or prevent radiation dermatitis in these patients. Preliminary results demonstrate a delayed onset of dermatitis, with onset of Grade 2 dermatitis at 5.1 (1.3) weeks in the chamomile group and 4.5 (1.3) weeks in the urea group (effect size of 0.46). Itching, burning and hyperpigmentation were more frequently reported in the urea group. Results indicates a potential efficacy of the chamomile gel. Further studies are needed to confirm the effect of the chamomile gel in reducing or delaying the occurrence of radiation dermatitis.
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Abreu AMD, Fraga DRDS, Giergowicz BB, Figueiró RB, Waterkemper R. Effectiveness of nursing interventions in preventing and treating radiotherapy side effects in cancer patients: a systematic review. Rev Esc Enferm USP 2021; 55:e03697. [PMID: 33978137 DOI: 10.1590/s1980-220x2019026303697] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 03/10/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To synthesize the best available evidence on the effectiveness of nursing interventions in radiotherapy patient care and to summarize the evidence on the experience and acceptability of interventions reported by health professionals involved in the prevention and treatment of side effects. METHOD A mixed-method systematic review. Quantitative and qualitative studies are presented. RESULTS Twelve studies published between 2013 and 2017 were included. Most interventions found focused on skin care, oral care, nausea and vomiting and nursing consultation. In accordance with high level of evidence and recommendation grade of the studies, the use of Calendula officinalis and thyme honey were considered effective for preventing and treating radiodermatitis and mucositis, respectively. CONCLUSION The quality of evidence of nursing interventions is weak. Although there are studies with a strong design and a high level of evidence, publication of nursing interventions is not enough and does not present a high quality to support practice to plan an effective patient-centered care.
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Affiliation(s)
- Aline Moraes de Abreu
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Porto Alegre, RS, Brazil
| | | | - Bruna Bastos Giergowicz
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Porto Alegre, RS, Brazil
| | | | - Roberta Waterkemper
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Porto Alegre, RS, Brazil
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Ginex PK, Backler C, Croson E, Horrell LN, Moriarty KA, Maloney C, Vrabel M, Morgan RL. Radiodermatitis in Patients With Cancer: Systematic Review and Meta-Analysis. Oncol Nurs Forum 2020; 47:E225-E236. [PMID: 33063778 DOI: 10.1188/20.onf.e225-e236] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION A systematic review and meta-analysis was conducted to inform the development of guidelines on the management of radiodermatitis among patients with cancer. LITERATURE SEARCH The authors updated a systematic review to include available literature published through September 30, 2019. DATA EVALUATION Two investigators assessed risk of bias using the Cochrane Collaboration risk-of-bias tool and certainty of the evidence using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. SYNTHESIS The use of deodorant/antiperspirant had no effect on development of radiodermatitis. Aloe vera and emu oil were equivalent or less effective than standard care. Oral curcumin had a minimal beneficial effect. Nonsteroidal topical interventions had a minimal beneficial effect on the development of moist desquamation and relief of itching while causing a small increase for grade 2 radiodermatitis. Topical calendula increased risk for the development of radiodermatitis. Topical steroids and dressings each showed benefits to minimize the development of radiodermatitis and moist desquamation while lowering rates of patient-reported symptoms, such as pain and pruritus. IMPLICATIONS FOR RESEARCH Symptom management strategies for radiodermatitis among patients with cancer that are likely to be effective include topical nonsteroidals, topical steroids, and dressings. SUPPLEMENTAL MATERIAL CAN BE FOUND AT HTTPS //bit.ly/2FWj3Kp.
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Gosselin T, Ginex PK, Backler C, Bruce SD, Hutton A, Marquez CM, McGee LA, Shaftic AM, Suarez LV, Moriarty KA, Maloney C, Vrabel M, Morgan RL. ONS Guidelines™ for Cancer Treatment-Related Radiodermatitis. Oncol Nurs Forum 2020; 47:654-670. [PMID: 33063779 DOI: 10.1188/20.onf.654-670] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Radiodermatitis is a side effect of radiation therapy. Evidence-based interventions to minimize severity or delay progression are important for clinical care. This guideline intends to support individuals with cancer, clinicians, and others in decisions regarding radiodermatitis treatment. METHODOLOGIC APPROACH A panel of healthcare professionals with patient representation was convened to develop a national clinical practice guideline for the management of radiodermatitis. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology and the National Academies of Sciences, Engineering, and Medicine criteria for trustworthy guidelines were followed. The Cochrane Collaboration risk-of-bias tool was used, and certainty of the evidence was assessed using the GRADE approach. A quantitative and narrative synthesis of the evidence was completed. FINDINGS The panel agreed on eight recommendations and made a conditional recommendation for deodorant/antiperspirant. Aloe vera and oral curcumin had knowledge gaps and were recommended only in the context of a clinical trial. The panel suggested against emu oil, calendula, and nonsteroidal interventions. IMPLICATIONS FOR NURSING This guideline summarizes evidence-based interventions for the management of radiodermatitis to guide clinical care. SUPPLEMENTARY MATERIAL CAN BE FOUND AT HTTPS //bit.ly/2GEwJtT.
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15
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Simões FV, Santos VO, Silva RND, Silva RCD. Effectiveness of skin protectors and calendula officinalis for prevention and treatment of radiodermatitis: an integrative review. Rev Bras Enferm 2020; 73:e20190815. [PMID: 33084806 DOI: 10.1590/0034-7167-2019-0815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 07/18/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE to analyze the effectiveness of skin protectors and Calendula officinalis for prevention and treatment of radiodermatitis. METHOD an integrative review conducted at CINAHL, Cochrane Library, Embase, MEDLINE/PubMed, IBECS, LILACS, and Web of Science. The final sample consisted of five studies, four clinical studies and one preclinical. Critical appreciation and narrative synthesis of the findings were carried out. RESULTS the Cavilon™ skin protector was more effective than Sorbolene (cream with 10% glycerin) and less effective than Mometasone Furoate cream. Calendula officinalis was more effective than Trolamine and essential fatty acids and less effective than Ching Wan Hung® for prevention and treatment of radiodermatitis. CONCLUSION data confirm the potential of Calendula officinalis for prevention and treatment of radiodermatitis and point to promising results regarding skin protector use; however, there is a need for further testing as to the effectiveness of such products.
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Affiliation(s)
| | - Valdete Oliveira Santos
- Instituto Nacional de Câncer José Alencar Gomes da Silva. Rio de Janeiro, Rio de Janeiro, Brazil
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16
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Siddiquee S, McGee MA, Vincent AD, Giles E, Clothier R, Carruthers S, Penniment M. Efficacy of topical Calendula officinalis on prevalence of radiation-induced dermatitis: A randomised controlled trial. Australas J Dermatol 2020; 62:e35-e40. [PMID: 32965030 DOI: 10.1111/ajd.13434] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/06/2020] [Accepted: 07/11/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES A randomised controlled trial was undertaken to compare the efficacy of topical Calendula officinalis (Calendula) versus standard of care (Sorbolene: 10% glycerine in cetomacragol cream) in reducing the prevalence of radiation-induced dermatitis in women undergoing breast cancer radiotherapy. METHODS A total of 271 women were screened and 82 were randomised. The primary outcome was prevalence of acute radiation-induced dermatitis (RTOG grade 2+) assessed at multiple skin sites. A chi-squared test was conducted for the primary outcome with a worst-case scenario imputation. RESULTS The recruitment target (n = 178) was not achieved. A total of n = 81 participants were analysed (n = 40 Calendula; n = 41 Sorbolene). There was no detectable difference in prevalence of radiation-induced dermatitis grade 2+ between the Calendula (53%) and Sorbolene (62%) groups (primary analysis OR = 0.87, 95% CI: [0.36, 2.09], P = 0.92; covariate adjusted complete case analysis OR 0.40, 95% CI: [0.13, 1.20], P = 0.10). CONCLUSION This randomised controlled trial showed no difference between Calendula and standard of care (Sorbolene) for the prevention of radiation-induced dermatitis. However, the study was underpowered (limited recruitment) for the primary comparison.
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Affiliation(s)
- Shihab Siddiquee
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Margaret A McGee
- Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, Australia
| | - Andrew D Vincent
- Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, Australia
| | - Eileen Giles
- Department of Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Robyn Clothier
- Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, Australia
| | - Scott Carruthers
- Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, Australia
| | - Michael Penniment
- Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, Australia
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17
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Marmitt DJ, Bitencourt S, Silva GRD, Rempel C, Goettert MI. RENISUS Plants and Their Potential Antitumor Effects in Clinical Trials and Registered Patents. Nutr Cancer 2020; 73:1821-1848. [PMID: 32835511 DOI: 10.1080/01635581.2020.1810290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 08/08/2020] [Accepted: 08/09/2020] [Indexed: 12/18/2022]
Abstract
Cancer is a significant cause of morbidity and mortality. Scientific advances, coupled with potential flaws in current treatments, are driving research into the discovery of new bioactive molecules. This systematic review focused on scientific studies with clinical trials and patents registered on the National Relation of Medicinal Plants of Interest to the Unified Health System (RENISUS) plants (or derivative compounds) with antitumor potential. Studies with 19 different forms of cancer were found, the prostate being the organ with the highest research incidence and the species Glycine max, Curcuma longa, and Zingiber officinale, beside the phytochemicals curcumin and soy isoflavone were the most tested in clinical trials/patents.
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Affiliation(s)
- Diorge Jônatas Marmitt
- Laboratório de Cultura de Células, Programa de Pós-graduação em Biotecnologia, Universidade do Vale do Taquari (Univates), Lajeado, Brazil
| | - Shanna Bitencourt
- Laboratório de Cultura de Células, Programa de Pós-graduação em Biotecnologia, Universidade do Vale do Taquari (Univates), Lajeado, Brazil
| | - Gustavo Rodrigo da Silva
- Centro de Ciências Biológicas e da Saúde, Universidade do Vale do Taquari (Univates), Lajeado, Brazil
| | - Claudete Rempel
- Programa de Pós-graduação em Ambiente e Desenvolvimento/Programa de Pós-graduação em Sistemas Ambientais Sustentáveis, Universidade do Vale do Taquari (Univates), Lajeado, Brazil
| | - Márcia Inês Goettert
- Laboratório de Cultura de Células, Programa de Pós-graduação em Biotecnologia, Universidade do Vale do Taquari (Univates), Lajeado, Brazil
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18
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Iacovelli NA, Torrente Y, Ciuffreda A, Guardamagna VA, Gentili M, Giacomelli L, Sacerdote P. Topical treatment of radiation-induced dermatitis: current issues and potential solutions. Drugs Context 2020; 9:dic-2020-4-7. [PMID: 32587626 PMCID: PMC7295106 DOI: 10.7573/dic.2020-4-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 02/08/2023] Open
Abstract
Approximately 95% of patients receiving radiotherapy (RT) will ultimately develop radiation-induced dermatitis (RID) during or after the course of treatment, with major consequences on quality of life and treatment outcomes. This paper reviews the pathophysiology of RID and currently used topical products for the prevention and treatment of RID. Although there is no consensus on the appropriate management, recent evidence suggests that the use of topical products supports to protect and promote tissue repair in patients with RID. Basic recommendations include advice to wear loose clothing, using electric razors if necessary, and avoiding cosmetic products, sun exposure or extreme temperatures. Based on mechanisms involved and on the clinical characteristics of oncological patients, the profile of the ideal topical product for addressing RID can be designed; it should have limited risk of adverse events, systemic adsorption and drug–drug interactions, should be characterized by multiple clinical activities, with a special focus on localized pain, and should have a careful formulation as some vehicles can block the RT beam.
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Affiliation(s)
| | - Yvan Torrente
- Stem Cell Laboratory, Department of Pathophysiology and Transplantation, Universitá degli Studi di Milano, Milan, Italy.,Unit of Neurology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Centro Dino Ferrari, Milan, Italy
| | - Adriana Ciuffreda
- Medico Chirurgo, Specialista in Dermatologia e Venereologia, Dermatologia Pediatrica, Milan, Italy
| | - Vittorio A Guardamagna
- Division of Palliative Care and Pain Therapy, IRCCS Istituto Europeo di Oncologia IEO, Milan, Italy.,Director of ESMO, Designated Center of Integrated Oncology and Palliative Care, Milan, Italy
| | | | - Luca Giacomelli
- Polistudium SRL, Milan, Italy.,Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | - Paola Sacerdote
- Department of Pharmacological and Biomolecular Science, University of Milano, Milan, Italy
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19
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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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20
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de Almeida EM, Ferreira HJ, Alves DR, da Silva WMB. Therapeutic potential of medicinal plants indicated by the Brazilian public health system in treating the collateral effects induced by chemotherapy, radiotherapy, and chemoradiotherapy: A systematic review. Complement Ther Med 2020; 49:102293. [PMID: 32147034 DOI: 10.1016/j.ctim.2019.102293] [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: 08/05/2019] [Revised: 11/13/2019] [Accepted: 12/30/2019] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE This study, through a systematic review, evaluated the therapeutic effect of medicinal plants that were of interest to the Unified Health System (SUS) in treating the side effects induced by chemotherapy, radiotherapy and chemoradiotherapy in cancer patients. METHODOLOGY According to the PRISMA guidelines, a systematic search was conducted in the PubMed, Lilacs and Scopus databases from January 2009 to December 2018, using the groups of descriptors (Cancer OR Neoplasia OR Tumor) and (controlled clinical trial OR randomized clinical trial) associated with the scientific names of the 71 medicinal plants described in RENISUS. The study is registered in PROSPERO CRD42019129927. RESULTS Of the 29 articles selected, only 17 demonstrated the therapeutic potential of plants included in RENISUS to prevent or treat the side effects induced by chemotherapy, radiotherapy or chemoradiotherapy, either solely or through an adjuvant effect from drugs already used in the medical clinic. The two plant-based therapies that had the most studies exploring their therapeutic potential on side effects were Zingiber officinale and Aloe vera. CONCLUSION This study showed that some plants listed in RENISUS have shown preventive and curative potential on side effects induced by conventional treatments in patients with different types of cancer. Therefore, the use of scientifically proven herbal products, in conjunction with conventional therapies, can contribute to a better quality of life in cancer patients undergoing conventional treatments.
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21
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Cardozo ADS, Simões FV, Santos VO, Portela LF, Silva RCD. SEVERE RADIODERMATITIS AND RISK FACTORS ASSOCIATED IN HEAD AND NECK CANCER PATIENTS. TEXTO & CONTEXTO ENFERMAGEM 2020. [DOI: 10.1590/1980-265x-tce-2018-0343] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To evaluate the association between sociodemographic, clinical, and treatment factors in the outcome of severe radiodermatitis in patients with head and neck cancer seen at the nursing consultation; and to analyze the impact of severe radiodermatitis cases on therapeutic follow-up. Method: A quantitative, documentary research conducted with medical records of 167 patients with head and neck cancer submitted to radiotherapy with curative indication followed in the nursing consultation in 2016. A structured form was used for data collection and analytical and descriptive statistics were used for its analysis. Results: Of the 99.4% patients who had radiodermatitis, 11.4% were severe cases. Severe radiodermatitis was associated with the type of equipment, treatment technique and presence of comorbidities. Of the patients who presented grade three, 53% had temporary discontinuation of treatment. Conclusion: Head and neck cancer patients who undergo radiotherapy with curative indication are at risk for severe radiodermatitis. Nursing consultation is important to minimize the severity of this event and the reduction of temporary treatment interruption due to this adverse reaction.
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22
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Cruceriu D, Balacescu O, Rakosy E. Calendula officinalis: Potential Roles in Cancer Treatment and Palliative Care. Integr Cancer Ther 2018; 17:1068-1078. [PMID: 30289008 PMCID: PMC6247547 DOI: 10.1177/1534735418803766] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A continuous challenge in cancer management is to improve treatment efficacy and
to diminish its side effects. Consequently, new conventional and unconventional
drugs and bioactive compounds from plants are constantly developed,
characterized, and used for in vitro and in vivo models. This review focuses on
the antitumor properties of Calendula officinalis, its
biological and molecular effects in tumor cells and animal models, as well as
its role in cancer palliative care. A systematic review of studies describing
the cytotoxic role of C officinalis and its therapeutic role on
cancer cells were carried out using the PubMed database. Albeit C
officinalis extracts have cytotoxic activity toward different
cancer cell lines, a high grade of variation between studies was observed,
depending on plant organ subjected to extraction, extraction method, and the
cancer cell lines used for each study. Nevertheless, its cytotoxic activity is
related to a few bioactive compounds, presenting multiple roles in both
activation of proapoptotic proteins and decreasing the expression of the
proteins that inhibit cell death. Moreover, due to its anti-genotoxic/protective
as well as antitumor and antimetastatic effects proven in animal models,
C officinalis could have important future implications in
developing novel cancer treatment strategies, while until now it has been used
especially for diminishing the side effects of radiotherapy.
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Affiliation(s)
- Daniel Cruceriu
- 1 The Oncology Institute "Prof. Dr. Ion Chiricuta," Cluj-Napoca, Romania.,2 "Babes-Bolyai" University, Cluj-Napoca, Romania
| | - Ovidiu Balacescu
- 1 The Oncology Institute "Prof. Dr. Ion Chiricuta," Cluj-Napoca, Romania.,3 University of Medicine and Pharmacy "Iuliu Hatieganu," Cluj-Napoca, Romania
| | - Elena Rakosy
- 2 "Babes-Bolyai" University, Cluj-Napoca, Romania
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23
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Rocha DDM, Pedrosa ADO, Oliveira ACD, Bezerra SMG, Benício CDAV, Nogueira LT. Evidências científicas sobre os fatores associados à qualidade de vida de pacientes com radiodermatite. Rev Gaucha Enferm 2018. [DOI: 10.1590/1983-1447.2018.2017-0224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo OBJETIVO Analisar na literatura os fatores associados à qualidade de vida de pacientes com radiodermatite. MÉTODO Revisão integrativa da literatura realizada nas bases de dados MEDLINE, CINAHL, Web of Science e IBECS, entre 2007 e 2016. RESULTADOS Foram analisados 14 estudos, que atenderam aos critérios de inclusão estabelecidos, com predomínio de ensaios clínicos randomizados, nível de evidência II 1. Dentre os fatores que comprometeram a qualidade de vida destacaram-se a dor, prurido, alteração da imagem corporal e reações emocionais como sintomas de ansiedade e depressão. A laserterapia, o óleo de emu e a radioterapia modulada por intensidade representaram as intervenções que favoreceram a melhoria da qualidade de vida. CONCLUSÃO A radiodermatite acarreta prejuízos significativos na qualidade de vida dos pacientes oncológicos, sendo necessárias intervenções multiprofissionais e novos estudos voltados para prevenção e tratamento da lesão.
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24
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Iacovelli NA, Galaverni M, Cavallo A, Naimo S, Facchinetti N, Iotti C, Fallai C, Orlandi E. Prevention and treatment of radiation-induced acute dermatitis in head and neck cancer patients: a systematic review. Future Oncol 2018; 14:291-305. [DOI: 10.2217/fon-2017-0359] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Acute dermatitis is the most common radio-induced side effect during treatment for head and neck cancer. The use of a wide variety of agents is reported to handle skin toxicity. Our aim was to review the literature and synthesize current available evidence. A comprehensive search was performed on multiple electronic databases until February 2017 and a systematic approach was carried out according to PRISMA guidelines. A total of 17 papers (950 patients on the whole) met the inclusion/exclusion criteria, with 12 randomized controlled trials and five nonrandomized observational and prospective studies. Generally speaking, there was no strong evidence to support the superiority of any specific intervention neither in prevention nor in therapeutic settings. Well-designed randomized studies including quality of life measurements are needed.
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Affiliation(s)
| | - Marco Galaverni
- Department of Medicine & Surgery, University of Parma, Italy
| | - Anna Cavallo
- Medical Physics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Simona Naimo
- Radiotherapy 2 Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Nadia Facchinetti
- Radiotherapy 2 Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Cinzia Iotti
- Radiation Oncology Unit, AUSL – IRCCS di Reggio Emilia, Italy
| | - Carlo Fallai
- Radiotherapy 2 Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Ester Orlandi
- Radiotherapy 2 Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Sak K, Nguyen TH, Ho VD, Do TT, Raal A. Cytotoxic effect of chamomile (Matricaria recutita) and marigold (Calendula officinalis) extracts on human melanoma SK-MEL-2 and epidermoid carcinoma KB cells. COGENT MEDICINE 2017. [DOI: 10.1080/2331205x.2017.1333218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
| | - Thi Hoai Nguyen
- Faculty of Pharmacy, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Viet Duc Ho
- Faculty of Pharmacy, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Thi Thao Do
- Institute of Biotechnology, The Vietnam Academy of Science and Technology, Hanoi, Vietnam
| | - Ain Raal
- Institute of Pharmacy, University of Tartu, Tartu, Estonia
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