• The Journal of Korean Medicine
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• v.43 no.4
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• pp.89-101
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• 2022

Objectives: The purpose of this systematic review was to evaluate the effects of herbal medicine on Chemo-Radiotherapy-induced oral mucositis. Methods: Electronic databases were used to search for studies published through 10 years until October 2022, and a randomized controlled study was conducted to evaluate efficacy of herbal medicine on chemo-radiotherapy-induced oral mucositis. Study quality was assessed using the Cochran's risk bias tool. Results: Two-hundred and three articles were initially searched, and 11 studies (head and neck cancer, breast cancer, colorectal cancer, esophageal cancer etc. undergoing radio-chemotherapy were included in analysis. The effect of herbal medicine on chemo-radiotherapy-induced oral mucositis, 9 studies reported that herbal medicine was more effective than the placebo group or conventional treatment. One study reported that the effect of the herbal compound treatment group was similar to that of the conventional herbal medicine, and one study reported that there was no difference in effect between the two herbal medicines and the group without treatment. Conclusion: This study suggests that herbal medicine effectively relieves the symptoms of chemo-radiotherapy-induced oral mucositis. However, there is limited evidence that herbal medicine may relief chemo-radiotherapy-induced oral mucositis, so further investigation is needed.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3611-3614
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• 2016

Background: Propolis based preparations have a wide range of applications in various specialties of dentistry. The aim of this clinical trial was to test the efficacy of propolis as a mouthwash in the reduction of chemotherapy induced oral mucositis (OM) in a single center. Materials and Methods: In this randomised, controlled study patients undergoing chemotherapy were included consecutively and randomised to an experimental group receiving propolis mouthwash (n = 20) and a control group receiving diluted water (n=20). Oral mucositis, erythema and eating and drink ability were assessed at baseline and after 3 and 7 days using the World Health Organization (WHO) scale and the oral mucositis assessment scale (OMAS). Results: There were significant differences in OM, wound and erythema in propolis group compared to placebo, but no significant difference in eating and drink ability. However, it was interesting that 65% of the patients in the propolis group were completely healed at day 7 of the trial. No significant adverse events were reported by the patients. Conclusions: This study found that oral care with propolis as mouthwash for patients undergoing chemotherapy is an effective intervention to improve oral health. Our findings shouldlencourage health practitioners to apply propolis mouth rinse for the oral care of patients under chemotherapy.

• Journal of Oral Medicine and Pain
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• v.25 no.4
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• pp.365-369
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• 2000

Oral mucositis or stomatitis produced by stomatotoxic chemotherapy and/or radiation therapy are painful, restrict oral intake and, importantly, act as sites of secondary infection and potals of entry for the endogenous oral microflora often leading to bacteremias or sepsis. A number of clinical observations and studies of animal model suggests a pathophysiological complexity in the development of mucositis. The condition appears to represent a sequential interaction of the oral mucosal cells and tissues, pro-inflammatory cytokines, and local environmental factors in the mouth. This article discussed and reviewed biological process of the mucositis and, the role of cytokines as initiators and amplifiers of the process. The recognition that the pathophysiology of mucositis is a multifactorial process has presented opportunities for intervention based upon biological attenuation.

• The Korean Journal of Pain
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• v.14 no.1
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• pp.51-55
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• 2001

Background: Oral mucositis is a common complication of anticancer chemotherapy. The sequelae of this consist of an increased risk of infection, moderate to severe pain, compromised oral function, and bleeding. This study was performed to evaluated the effects of the He-Ne laser and the Ga-Al-As laser on oral mucositis caused by anticancer chemotherapy in pediatric patients. Methods: There were 3 cases of osteosarcoma and 6 cases of leukemia. All patients received He-Ne laser (632.8 nm wavelength, power 60 mW) application on 400-600 Hz scanning for 5-20 minutes and Ga-Al-As laser (904 nm wavelength, power 40 mW) application by fiberoptic hand piece placed in immediate proximity to the tissue without direct contact with it for 30 seconds per point for 5 days per week. During the application patients wore wavelength-specific dark glasses and were instructed to keep their eyes closed. Results: The mean number of treatments with oral intake was $4.89{\pm}0.64$. The mean number of total treatments was $9.44{\pm}2.59$. There were no significant side effects during and after the laser treatments. Conclusions: He-Ne laser and Ga-Al-As (IR) laser treatment were well tolerated and reduced the severity and duration of chemotherapy-induced oral mucositis in pediatric oncologic patients.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.413-418
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• 2016

Objective: To assess the safety and effectiveness of a mouth-rinse with G-CSF (JiSaiXin, produced by NCPC Biotechnology Co., Ltd) in treating patients with chemotherapy-induced oral mucositis (CIM). Method: A consecutive cohort of patients with advanced cancers and CIM were treated with mouth-rinse G-CSF. All chemotherapy for patients with advanced cancers was adopted from regimens suggested by NCCN guidelines. The mouth-rinse with G-CSF at a dose of 150-300ug plus 100ml-500ml normal saline was started from the time of oral mucositis was confirmed and continuously used for at least 7 days as one course. After at least two courses of treatment, safety and efficacy were evaluated. Results: There were 7 female and 7 male patients with advanced cancer and CIM recruited into this study, including 5 with colorectal, 2 with lung, 1 patient with gastric, 1 with cervical and 1 with pancreatic cancer, as well as 2 patients with diffuse large B cell lymphomas, 1 with nasopharyngeal and 1 with gastric cancer. The median age was 57 (41-79) years. Grade 1 to 2 myelosuppression was observed in 3/14 patients, and Grade 4 myelosuppression in 1/14. Adverse effects on the gastrointestinal tract were documented in 5/14 patients, and were Grade 1 to Grade 3. No treatment related death was documented. Regarding CIM, the median response time to mouth rinse of G-CSF was 2 (1-5) days, and all patients with CIM demonstrated a positive response. Conclusions: Mouth-rinse with G-CSF proved to be safe and effective in treating patients with advanced cancers and CIM. However, further randomized controlled studies should be conducted to clarify the effectiveness of this treatment with other lesions.

• Journal of Digestive Cancer Research
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• v.3 no.2
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• pp.76-81
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• 2015

Gastrointestinal side effects including nausea and vomiting, diarrhea, constipation, oral mucositis and colitis, and hepatotoxicity are common occurrence during chemotherapy. Often they result in unplanned admission and interruption of scheduled therapy. Additionally they have a negative influence on patient's therapeutic outcome and quality of life. The assessment of gastrointestinal side effects is dependent on clinician assignment of a grade established by the National Cancer Institute Common Terminology Criteria for Adverse Events. Continued interest of gastrointestinal side effects has allowed identifying patients at higher risk and providing effective treatments to relieve painful symptom. Finally, proper prevention and management of chemotherapy-induced gastrointestinal side effects will be needed to improve patient's survival and quality of life.

• Radiation Oncology Journal
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• v.24 no.1
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• pp.67-76
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• 2006

Purpose: Oral mucositis is a common toxicity of radiation or chemotherapy, which is used a treatment for head and neck cancer. We investigated effects of recombinant human epidermal growth factor (rhEGF) on radiation-induced oral mucositis in rat model. Materials and Methods: Spraque-Dawley rats (7 per group) exposed to a single dose of 25 Gy (day 0) on their head, except for one group, were randomly divided into un-treated, vehicle-treated, and two rhEGF-treated groups. Rats were topically applied with rhEGF (15 or $30{\mu}g/oral$ cavity/day) or vehicle to their oral mucosa. Survival rate of rats, weight changes, and food intakes were examined from day 0 to 18 after radiation. Histology study was performed from oral mucosa of rats at day 7 and 18 after radiation. Results: rhEGF-treated groups (15 or $30{\mu}g/oral$) showed all survival rate 33%, whereas un-treated and vehicle-treated groups showed all survival rate 0% at the end of experiment. rhEGF-treated groups statistically had less weight loss compared to vehicle-treated group from day 2 to 7 after radiation. Food intake of rats with rhEGF treatment turned to increase at day 14 after radiation. At 7 day after radiation, un-treated and vehicle-treated groups showed severe pseudomembraneous or ulcerative oral mucositis. On the other hand, rhEGF-treated groups had no more than cellular swelling and degeneration of epidermal cells in oral mucosa of rats. Conclusion: These results suggest that rhEGF has significantly positive effects on radiation-induced oral mucositis in rats. rhEGF display a therapeutic potential on a clinical level.

• Journal of Korean Academy of Nursing
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• v.25 no.1
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• pp.5-16
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• 1995

The effects of the mouth care using cool sterile normal saline on oral stomatitis were investigated in 59 patients on chemotherapy. The subjects were divided into two groups, one was experimental group(N=31) in which the subjects were provided mouth care 4 times a day (after meals, before bedtime)with cool normal saline, the other was the control group(N=28), The Oral Assessment Guide(OAG) which it includes eight items(voice, swallowing, lips, tongue, salivation, oral mucous membrane, gingiva & teeth) was used to assess oral status six times(once in the Prechernotherapy Period, and on the third, 5th, 7th, 10th & 14th day postchemotherapy). The means of the total scores at each time were analyzed by repeated ANOVA The results are as follows : 1. The incidence of stomatitis was higher in the control group than in experimental group. The incidence of third grade stomatitis characterized by bleeding, sore, infection & severe pain was 3.3% in the experimental group, and while 21.4% in the control group(p=0.01). 2. The number of stomatitis sites which were occurred in the experimental group were significantly lower than in the control group(p=0.046). 3. The grade of stomatitis(mean of total score) for patients in the control group was significantly higher than for patients in the experimental group (p=0.005). 4. In the control group, voice change increased in the period between the seventh and tenth day after chemotherapy (p=0.04). 5. In the control group, swallowing difficulty was mest severe in the period between seventh and tenth day(p=0.05), and decreased by the fourteenth day(p=0.01). 6. Changes in the lips gradually increased after chemotherapy in the control group(p=0.0025), while they were significantly lower in the experimental group(p=0.0002). 7. The increment of tongue changes started on the third day after chemotherapy reached a peak on the tenth day and decreased by the fourteenth day in both groups(p=0.0016). 8. Driness of the mouth reached a peak on the seventh day after chemotherapy in the control group (p=0.05). 9. The degree of oral mucositis was significantly higher in the control group than in the experimental group(p=0.02) . In the control group, the mucosal change started three days after chemotherapy and reached a peak on the tenth day(p=0.03). 10. Changes in the gingia were significantly higher in the control group(p=0.03). In control group, the degree of gingivitis reached a peak on the tenth day. In conclusion, meuth care with normal saline four times a day could reduce the incidence and grade of stomatitis. Stomatitis was shown to begin on the third day after chemetherapy, reach a peak on the tenth day and be reduced by fourteenth day.