Head and Neck Cancer Patients
Conditions
Keywords
xerostomia, thyme honey, nitric oxide
Brief summary
Xerostomia is the most frequent complication among patients who receive radiotherapy (RT) . The prevalence of xerostomia has been reported to be from 73.5% to 93% (Kakoei S.,2012). Damage to normal tissues can result by radiotherapy as it is not selective to cancer cells, and so affecting the quality of life of patients. Honey is one of the methods studied by CIM for management of HNC treatment side effects due to its properties. (Brennan et al., 2002; Clarkson et al., 2007; Furness et al., 2011;Hackett et al., 2015). Thyme honey is a new alternative for management of xerostomia, which is a propolis gel product. Thyme honey is a variety of monofloral honey made from the nectar and pollen of thyme flowers. It has a strong antioxidant, antibacterial, antifungal and immuno modulating health effects. Due to the high sugar concentration in honey, it is believed that its presence in the oral cavity has a sialogogue effect, stimulating the salivary glands to produce saliva.
Detailed description
90 post radiation cancer patients were randomly assigned into two equal groups.The intervention group will have oral rinses (20 ml of thyme honey diluted in 100 ml of purified water) 3 times per day starting in the 4th week of radiotherapy and for one month after completion of radiotherapy. Patients in the control arm followed the same protocol with normal saline rinses. The treatment assessment of subjective dry mouth score, objective dry mouth score, salivary Ph and salivary flow rate will be carried out at baseline, 2 weeks and one month after starting of the treatment protocol (Charalambous et al., 2017). Nitric oxide levels will be measured at baseline and after one month of treatment (Abadi et al., 2020).
Interventions
DRUGthyme honey mouth rinse
oral rinses (20 ml of thyme honey diluted in 100 ml of purified water) 3 times per day starting in the 4th week of radiotherapy and for one month after completion of radiotherapy. (Charalambous et al.,2017)
saline mouth rinse 3 times per day starting in the 4th week of radiotherapy and for one month after completion of radiotherapy
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
25 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Patients referred to non-palliative head and neck radiotherapy * Total dose of radiation received (50-70 Gy) * Patients with complaint of xerostomia * Age 25-65 years old * Objective dry mouth score from ( 2-5) * Subjective dry mouth score from (1-4) * Undergoing radiotherapy for at least three weeks * Can independently complete the questionnaire
Exclusion criteria
* Have confirmed systemic diseases or medications associated with xerostomia * Have a known allergy to honey * Patients who had salivary glands removal surgery * Patients with salivary gland diseases or malignancy * Vulnerable groups such as pregnant females, prisoners, mentally and physically handicapped individuals.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| subjective dry mouth score | change from baseline at 4 weeks | Q1. Do you feel dryness in your mouth ? Q2. Do you drink liquids to help you swallow dry food? Q3. Do you feel mouth dryness when eating a meal? Q4. Does the saliva seem to be too little in your mouth? Subjects who answered confirmatively to at least one of those questions related to dry mouth will be considered as positive for oral dryness subjective complaints. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| objective dry mouth score | change from baseline at 4 weeks | Objective dry mouth score: The patients will be examined for their signs of dry mouth including: (Osailan et al., 2011). 1. pooled saliva loss 2. stickiness of mouth mirror to buccal mucosa 3. stringy or foamy appearance of saliva 4. dehydration of the lips 5. no response to parotid stimulation Calculation of Objective dry mouth scores will be according to the number of dry mouth signs observed (0-5) and patients with less than 2 score will be excluded |
| salivary PH | change from baseline at 4 weeks | identification of PH according to the color of the PH paper |
| nitric oxide levels | change from baseline at 4 weeks | assessment of nitric oxide levels in the salivary samples using ELISA |
| Salivary flow rate | change from baseline at 4 weeks | assessing unstimulated salivary flow rate in 5 minutes |
Countries
Egypt
Outcome results
None listed