ANTI-INFLAMMATORY EFFECT OF NIGELLA SATIVA OIL ON CHEMORADIATION-INDUCED ORAL MUCOSITIS IN PATIENTS WITH HEAD AND NECK CANCERS
Objective: Oral mucositis (OM) is a common treatment-induced toxicity in patients undergoing radiation or chemoradiation for head and neck cancers (HNC). The study aims to evaluate the anti-inflammatory effect of Nigella sativa (NS) oil in radiation-or chemoradiation-induced OM in HNC patients.
Methods: From Forty HNC patients were randomized to two groups, each of 20 patients. The first group was treated with NS oil mouthwash five times daily, while the second group was treated with the Magic mouthwash and served as a control. All patients received radiotherapy (RT) (60-70 Gy) in 30-35 fractions over 6-7 w with or without chemotherapy. Patients were evaluated once per week to estimate the severity and duration of OM and the salivary levels of IL-6 and TNF-α.
Results: 70% of patients were men and the commonest tumor locations were larynx (47.5%) and pharynx (22.5%) classified as stages III or IV. NS oil significantly reduces RTOG grade and OM severity after 3-4 w of RT, attenuates the elevation in salivary IL-6 and TNF-α production after 3-5 w.
Conclusion: Nigella sativa oil mouthwash have a potential anti-inflammatory activity that may be beneficial in minimizing or preventing radiation-or chemoradiation-induced oral mucositis in patients with head and neck cancer.
2. Khanal B, Baliga M, Uppal N. Effect of topical honey on limitation of radiation-induced oral mucositis: an intervention study. Int J Oral Maxillofac Surg 2010;39:1181-5.
3. Elting LS, Cooksley CD, Chambers MS. Risk, outcomes, and costs of radiation-induced oral mucositis among patients with head-and-neck malignancies. Int J Radiat Oncol Biol Phys 2007;68:1110-20.
4. Wong HM. Oral complications and management strategies for patients undergoing cancer therapy. Sci World J 2014. http://dx.doi.org/10.1155/2014/581795
5. Hadjieva T, Cavallin Stahl E, Linden M. Treatment of oral mucositis pain following radiation therapy for head-and-neck cancer using a bioadhesive barrier-forming lipid solution. Support Care Cancer 2014;22:1557-62.
6. Peterman A, Cella D, Glandon G. Mucositis in head and neck cancer: economic and quality of life outcomes. J Natl Cancer Inst Monogr 2001;29:45-51.
7. Rodriguez Caballero A, Torres Lagares D, Robles Garcia M. Cancer treatment-induced oral mucositis: a critical review. Int J Oral Maxillofac Surg 2012;41:225-38.
8. Tariq M. Nigella sativa feeds: folklore treatment in modern-day medicine. Saudi J Gastroenterol 2008;14:105-6.
9. Gaur S, Shrivastava B, Gaur S. Medicinal and therapeutic potential of Nigella sativa. Int J Med Appl Sci Res 2014;1:32-9.
10. Amin B, Hosseinzadeh H. Black cumin (Nigella sativa) and its active constituent, thymoquinone: an overview on the analgesic and anti-inflammatory effects. Planta Med 2016;82:8-16.
11. Ustun K, Taysi S, Sezer U. Radio-protective effects of Nigella sativa oil on oxidative stress in tongue tissue of rats. Oral Dis 2014;20:109-13.
12. Al-Douri A, Al-Kazaz S. The effect of Nigella sativa oil (black seed) on the healing of chemically induced oral ulcer in rabbit (experimental study). Al-Rafidain Dent J 2010;10:151-7.
13. Lotfy AO, Zayed M. Immunohistochemical study of the effect of Nigella Sativa L. extract on chemotherapy-induced oral mucositis in albino rats. Cairo Dental J 2009;25:159-66.
14. Navazesh M. Method for collecting saliva. Ann N Y Acad Sci 1993;694:72-7.
15. Su CK, Mehta V, Ravikumar L. Phase II double-blind, randomized study comparing oral aloe vera versus placebo to prevent radiation-related mucositis in patients with head-and-neck neoplasms. Int J Radiat Oncol Biol Phys 2004;60:171-7.
16. Rao S, Dinkar C, Vaishnav LK. The Indian spice turmeric delays and mitigates radiation-induced oral mucositis in patients undergoing treatment for head and neck cancer: an investigational study. Integr Cancer Ther 2013;13:201-10.
17. Das D, Agarwal SK, Chandola HM. Protective effect of Yashtimadhu (Glycyrrhizaglabra) against side effects of radiation/chemotherapy in head and neck malignancies. Ayu 2011;32:196-9.
18. Aghamohammadi A, Moslemi D, Akbari J. The effectiveness of Zataria extract mouthwash for the management of radiation-induced oral mucositis inpatients: a randomized placebo-controlled double-blind study. Clin Oral Invest 2018;22:2263-72.
19. Huang EY, Leung SW, Wang CJ. Oral glutamine to alleviate radiation-induced oral mucositis: a pilot randomized trial. Int J Radiat Oncol Biol Phys 2000;46:535-9.
20. Rao NG, Trotti A, Kim J. Phase II multicenter trial of caphosol for the reduction of mucositis in patients receiving radiation therapy for head and neck cancer. Oral Oncol 2014;50:765-9.
21. Lievens Y, Haustermans K, Van den Weyngaert D. Does sucralfate reduce the acute side-effects in head and neck cancer treated with radiotherapy? A double-blind, randomized trial. Radiother Oncol 1998;47:149-53.
22. Le QT, Kim HE, Schneider CJ. Palifermin reduces severe mucositis in definitive chemoradiotherapy of locally advanced head and neck cancer: a randomized, placebo-controlled study. J Clin Oncol 2011;29:2808-14.
23. Henke M, Alfonsi M, Foa P. Palifermin decreases severe oral mucositis of patients undergoing postoperative radiochemotherapy for head and neck cancer: a randomized, placebo-controlled trial. J Clin Oncol 2011;29:2815-20.
24. Bossi P, Locati LD, Licitra L. Palifermin in the prevention of head and neck cancer radiation-induced mucositis: not yet a definitive word on safety and efficacy profile. J Clin Oncol 2012;30:564-5.
25. Citrin DE, Hitchcock YJ, Chung EJ. Determination of cytokine protein levels in oral secretions in patients undergoing radiotherapy for head and neck malignancies. Radiat Oncol 2012;7:64.
26. Bossi P, Bergamini C, Miceli R. Salivary cytokine levels and oral mucositis in head and neck cancer patients treated with chemotherapy and radiation therapy. Int J Radiat Oncol Biol Phys 2016;96:959-66.
27. Gholamnezhad Z, Havakhah S, Boskabady MH. Preclinical and clinical effects of Nigella sativa and its constituent, thymoquinone: a review. J Ethnopharmacol 2016;190:372-86.
28. Meirovtz A, Kuten M, Billan S. Cytokines levels, the severity of acute mucositis and need of PEG tube installation during chemo-radiation for head and neck cancer–a prospective pilot study. Radiat Oncol 2010;5:16.
29. Morales Rojas T, Vieira N, Moron Medina A. Proinflammatory cytokines during the initial phase of oral mucositis in patients with acute lymphoblastic leukemia. Int J Paedatr Dent 2012;22:191-6.
30. Min CK, Lee WY, Min DJ. The kinetics of circulating cytokines including IL-6, TNF-alpha, IL-8 and IL-10 following allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2001;28:935-40.
31. Sonis ST. The pathobiology of mucositis. Nat Rev Cancer 2004;4:277-84.
This work is licensed under a Creative Commons Attribution 4.0 International License.