Brazilian organic propolis for prevention and treatment of radiation-related oral acute toxicities in head and neck cancer patients: A double-blind randomized clinical trial.

Autor:	Fernandes PM; Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil., Rosalen PL; Department of Bioscience, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.; Biological Sciences Graduate Program, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil., Fernandes DT; Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil., Dias-Neto E; Laboratory of Medical Genomics, Research International Center (CIPE), A.C. Camargo Cancer Center, São Paulo, São Paulo, Brazil., Alencar SM; Department of Agri-food Industry, Food and Nutrition, 'Luiz de Queiroz' College of Agriculture, University of São Paulo, Piracicaba, São Paulo, Brazil., Bueno-Silva B; Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil., Alves FA; Stomatology Department, A.C. Camargo Cancer Center, São Paulo, São Paulo, Brazil., Lopes MA; Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	Frontiers in pharmacology [Front Pharmacol] 2022 Oct 07; Vol. 13, pp. 973255. Date of Electronic Publication: 2022 Oct 07 (Print Publication: 2022).
DOI:	10.3389/fphar.2022.973255
Abstrakt:	Background: Oral mucositis (OM) is one of the most important acute toxicities from radiotherapy (RT) in head and neck cancer patients and can impair oncologic treatment. Dysphagia, dysgeusia, pain, and oral candidiasis are other common toxicities. Brazilian Organic Propolis (BOP) is a recently described propolis variant and BOP types 4 and 6 have shown important antioxidant, anti-inflammatory, and antifungal properties. Purpose: To investigate the use of BOP as a preventive and/or complementary therapeutic option for radiotherapy-induced oral mucositis, dysphagia, dysgeusia, pain, and oral candidiasis. Additionally, proinflammatory cytokines were assessed to investigate their anti-inflammatory role. Methods: Sixty patients were included in this randomized, double-blind, controlled clinical trial. Patients were randomized to receive either aqueous suspension of a BOP or placebo throughout RT. Also, all patients underwent low-level laser therapy as routine oral care. OM, dysphagia, and dysgeusia were assessed weekly according to WHO and NCI scales. Pain-related to OM was assessed according to a Visual Analog Scale and the presence or absence of oral candidiasis was checked by intraoral examination. Protein levels of TNF-α and IL-1β from oral mucosa were assessed by ELISA. Results: Patients in the propolis group had a lower mean score of OM, dysphagia, dysgeusia, and most patients reported moderate pain. Fewer patients developed oral candidiasis in the propolis group, and the number of episodes was lower among patients that used BOP ( p < 0.05). In addition, the BOP group presented significantly lower levels of IL-1β since the beginning of treatment when compared with placebo patients ( p < 0.05) and a lower level of TNF-α at the end of treatment ( p < 0.001). Conclusion: Topic use of BOP reduced TNF-α and IL-1β levels, oral candidiasis episodes, and seems to be a useful complementary option for the prevention and treatment of the main acute oral toxicities of RT. Clinical Trial Registration: http://www.ensaiosclinicos.gov.br/rg/RBR-9f8c78/, identifier RBR-9f8c78. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Fernandes, Rosalen, Fernandes, Dias-Neto, Alencar, Bueno-Silva, Alves and Lopes.)
Databáze:	MEDLINE
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