RESUMEN
OBJECTIVES: Radiation-induced mucositis (RIOM) is one of the most common side effects from head and neck radiotherapy. Several reagents have been introduced to manage the symptom; however, there is still a limited number of effective reagents. Herbal mouthwashes with payayor (Clinacanthus nutans Lindau) and fingerroot (Boesenbergia rotunda) were tested their efficacies in preventing and reducing severity of RIOM in comparison with normal saline with sodium bicarbonate. METHODS: One hundred twenty patients with head and neck cancer undergoing radiotherapy participated in the study and were randomly assigned into three treatment groups using block randomization method. The participants were assigned one of the three mouthwashes for use throughout their radiotherapy course and were assessed for their mucositis scores from week one to six into their radiotherapy course as well as at one-month follow-up. Body mass index was also measured for comparison of nutritional status. RESULTS: The two mouthwashes were similarly effective in prophylaxis of RIOM in term of severity. The averaged mucositis scores were less than two for all groups. For the onset of RIOM, both herbal mouthwashes could slightly delay the symptom but not statistically significant. Patients' body mass index across the three treatment groups was also comparable. The patients were largely satisfied with all the mouthwashes with no clear preference on any of them. CONCLUSIONS: Prophylactic treatment of RIOM using herbal mouthwashes could substitute the current standard of normal saline with bicarbonate. A different formulation of the two herbs could potentially improve the prophylactic outcome. TRIAL REGISTRATION NO: NCT03359187.
Asunto(s)
Neoplasias de Cabeza y Cuello , Mucositis , Traumatismos por Radiación , Estomatitis , Bicarbonatos/uso terapéutico , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Neoplasias de Cabeza y Cuello/radioterapia , Humanos , Antisépticos Bucales/uso terapéutico , Mucositis/tratamiento farmacológico , Traumatismos por Radiación/tratamiento farmacológico , Traumatismos por Radiación/prevención & control , Solución Salina/uso terapéutico , Bicarbonato de Sodio/uso terapéutico , Estomatitis/tratamiento farmacológico , Estomatitis/etiología , Estomatitis/prevención & controlRESUMEN
PURPOSE: An exploration of concurrent chemoradiation therapy care process from the perspective of patients with head and neck cancer can provide an insight to their lived experience and the difficulties they encounter in daily life towards a deeper understanding of this phenomenon to shape nursing service delivery. The aims of this study were to explore the lived experiences of patients with head and neck cancer while receiving concurrent chemoradiation therapy. METHODS: Data were generated from individual in-depth interviews with fifteen head and neck cancer patients, according to the semi-structured interview guidelines, at the out-patient radiation oncology department, Chulabhorn Cancer Center, Bangkok, Thailand. RESULTS: By using Graneheim and Lundman's content analysis, three categories from the data analysis of patients with head and neck cancer receiving concurrent chemoradiation therapy were isolated: 1) overwhelming information, 2) unpleasant symptom cluster, and 3) strategy for adherence to treatment regimen. CONCLUSION: The findings help to provide a better understanding of the lived experiences of patients with head and neck cancer during concurrent chemoradiation therapy, in terms of their suffering from various unpleasant side effects and how these impact their life along the treatment journey. This perspective on the care process in these patients enhances the development of a nursing care model based on patient-centered care toward positive patient outcomes.
Asunto(s)
Quimioradioterapia/métodos , Neoplasias de Cabeza y Cuello/terapia , Calidad de Vida , Carcinoma de Células Escamosas de Cabeza y Cuello/terapia , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/psicología , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Investigación Cualitativa , Carcinoma de Células Escamosas de Cabeza y Cuello/patología , Carcinoma de Células Escamosas de Cabeza y Cuello/psicología , Tasa de SupervivenciaRESUMEN
Radiation-induced toxicity is a major limiting factor for prescribing radiation dose in cancer radiotherapy. Skin reaction to radiation is one of the primary concerns, which could affect quality of life of the patients both physically and mentally. Reviews of the literature show limited number of effective reagents for its prophylaxis. In this study, we attempted to determine whether prophylactic treatment of the 3 different herbal creams containing Centella asiatica, Cucumis sativus, and Thunbergia laurifolia extracts as well as a commercial moisturizing cream could reduce acute skin reaction in breast cancer patients undergoing radiotherapy. A total of 153 breast cancer patients undergoing radiotherapy were randomly assigned into 5 different groups with one group receiving no treatment. The patients were instructed to apply their designated creams once daily from their first radiotherapy session until 1-month post-irradiation. Their skins were graded by a radiation oncologist on a weekly basis until 1-month post-irradiation to identify any skin reactions. The results showed that the administration of the herbal creams or the moisturizing cream could neither reduce the severity nor delay the onset of dermatitis compared with the no treatment group. However, despite the limited benefits from the prophylaxis, the Cucumis sativus cream was shown to help with the skin recovery post-irradiation. These results suggested that breast cancer patients undergoing radiotherapy should be advised to apply moisturizing cream to the area of irradiated skin.