“A COMPARATIVE STUDY OF EFFICACY AND SAFETY OF TOPICAL CURCUMIN VERSUS 1% POVIDONE IODINE IN RADIOTHERAPY INDUCED ORAL MUCOSITIS PATIENTS WITH HEAD AND NECK CANCER AT A TERTIARY CARE HOSPITAL”
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Keywords
Radiotherapy ; oral mucositis ; Curcumin ; Povidone Iodine; Turmeric extract
Abstract
BACKGROUND: Radiotherapy has been the most common modality for treating human cancers needed by 80% of cancer patients at some time or other, either for curative or palliative purposes. Damage to cells by radiotherapy is potentiated or mitigated by depending on several factors. Oral mucositis is a common complication and a dose limiting toxicity in up to 90% of head & neck cancer patients (HNCP) undergoing radio-chemotherapy. Several adjuvant agents like folic acid, Vit-E, antibiotic mouth rinse etc. have been tried without remarkable success. Curcumin is known to have antioxidant and free radical scavenging activity that had shown its radio protective potential in in vitro studies. The study objective is to evaluate the efficacy and safety of Curcumin versus Povidone Iodine among radiotherapy induced oral mucositis in head & neck cancer patients
METHODS: 60 patients with radiotherapy induced mucositis were equaly randomized into two groups of 30 each to receive either 10 ml Curcumin mouthwash TID or 1:100 diluted 1ml Povidone Iodine solution mouthwash TID for 12 weeks. Efficacy was measured by reduction in pain Numerical Rating score (NRS) and Radiation Therapy Oncology Group (RTOG) score at week 4, 8 and 12 from baseline. Safety was assessed by monitoring treatment emergent adverse effects. Data analysed by using repeated measure ANOVA test with repeated measure analysis and with Bonferroni corrections. RESULTS: The baseline mean NRS ( p = 0.90) and RTOG score ( p = 0.7) score was comparable between the two groups. The mean NRS and RTOG score was 5.2 (2.75) and 2.9 (0.78) in Curcumin group, 5.5 (2.47) and 2.4 (0.85) in Povidone Iodine group. The mean NRS and RTOG score after 12 weeks of treatment was 0.6 (0.75) and 1.1 (0.30) in Curcumin group and 1.9 (0.80) and 1.5 (0.57) in Povidone Iodine group. Curcumin and Povidone Iodine both groups effectively reduced NRS and RTOG score compared to baseline at the end of 12 weeks. No significant adverse effects were noted.
CONCLUSION: Turmeric extract, Curcumin mouth wash significantly reduced NRS and RTOG score as compared to 1% Povidone Iodine with no significant adverse effects and thus can be favourable therapeutic option in patients with radiotherapy induced oral mucositis.
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Dr Gandham Ravi
Assistant Professor, Department of Pharmacology, NSMCH, Amhara, Bihta, Patna
Dr Vishnu K
Assistant Professor, Department of Pharmacology, Shri Atal Bihari Vajpayee Medical college & Research Institute, Bangalore, Karnataka, India
Dr Kiran Warrier
Medical advisor, Novo Nordisk India Pvt Ltd Bengaluru, Karnataka, India
Dr Shruti Ayyappanavar
Senior resident, Department of Pharmacology, ESIC-MC PGIMSR, Bangalore, Karnataka, India. Shriram sameeksha, 17th tower 401,Gangamma gudi police station road, Kuvempu nagar,East Jalahalli, 560013