Oral mucositis management with photobiomodulation, Bidens pilosa L. (Asteraceae) and Curcuma longa L. (Zingiberaceae), the FITOPROT herbal medicine, and its influence on inflammatory cytokine levels: a randomized clinical trial.

Diego Antonio Costa Arantes, Artur Christian Garcia da Silva, Elismauro Francisco Mendonça, Allisson Filipe Lopes Martins, Carlos Henrique Pereira, Marília Oliveira Morais, Sebastião Silvério de Sousa-Neto, Marize Campos Valadares, Nilceana Maya Aires Freitas, Cláudio Rodrigues Leles, Victor Hugo Lopes De Oliveira Moreira

Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 2024;32(9):628

PMID: 39223301

Abstract

PURPOSE

This randomized clinical trial aimed to compare the effects of a mucoadhesive formula, containing curcuminoids from Curcuma longa L. and glycerinated extract of Bidens pilosa L. (FITOPROT), associated with photobiomodulation (PBM), and of PBM exclusively, on the incidence of oral mucositis (OM)-induced by radiotherapy (RT) in the head and neck region, and the salivary expression of inflammatory cytokines, in patients with head neck cancer.

METHODS

Patients were randomly assigned into two intervention groups-FITOPROT + PBM (n = 25) or PBM (n = 27). PBM protocol comprised a wavelength of 660 nm, 25 mW, 0.25 J/point, and daily irradiation from the first until the last day of RT. FITOPROT was gargled twice a day. All patients underwent a preventive oral care program throughout the study. OM degree, salivary concentration of nitrite, and inflammatory (IL-1, TNFα, IL-6, IL-8, and IL-12p70), and anti-inflammatory (IL-10) cytokines were assessed at baseline, and at the 7th, 14th, 21st, and 30th RT sessions.

RESULTS

There were no differences in the OM degree between groups, but the RT dose significantly affected the OM. The RT significantly affected the salivary nitrite, TNFα, IL-1β, and IL-10 concentrations.

CONCLUSION

FITOPROT associated with PBM showed limited effects on preventing the incidence of severe OM compared to PBM alone. However, FITOPROT + PBM may be associated with nitrite and cytokine balance, which may contribute to the occurrence of fewer cases of severe OM.

TRIAL REGISTRATION

Brazilian Clinical Trials database (ReBEC; RBR-9vddmr), registered UTN code: U1111-1193-2066, registered in August 8th, 2017.

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Address: Araujo Jorge Cancer Hospital, R. 239, 206 - Setor Universitário, Goiânia, Goiás, CEP 74175-120, Brazil.; Department of Oral Diagnosis, School of Dentistry, Universidade Evangélica de Goiás, Dentistry School, Anápolis, Goiás, CEP 75083-515, Brazil.; Laboratory of Oral Pathology, School of Dentistry, Universidade Federal de Goiás, Avenida Universitária Esquina Com 1ª Avenida, S/N. Setor Universitário, Goiânia, Goiás, CEP 74605-220, Brazil.; Laboratory of Education and Research in In Vitro Toxicology, Tox In, Faculty of Pharmacy, Universidade Federal de Goiás, Rodovia R2, N. 3.061, Campus Samambaia, Goiânia, Goiás, CEP 74605.170, Brazil.; Department of Radiotherapy, Araujo Jorge Cancer Hospital, R. 239, 206-Setor Universitário, Goiânia, Goiás, CEP 74175-120, Brazil.; Department of Prevention and Oral Rehabilitation, School of Dentistry, Universidade Federal de Goiás, Avenida Universitária Esquina Com 1ª Avenida, S/N. Setor Universitário, Goiânia, Goiás, CEP 74605-220, Brazil.; Laboratory of Oral Pathology, School of Dentistry, Universidade Federal de Goiás, Avenida Universitária Esquina Com 1ª Avenida, S/N. Setor Universitário, Goiânia, Goiás, CEP 74605-220, Brazil. [email protected].

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