Yamashita Taku, Araki Koji, Tomifuji Masayuki, Kamide Daisuke, Tanaka Yuya, Shiotani Akihiro
Department of Otorhinolaryngology-Head & Neck Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 3598513, Japan,
Support Care Cancer. 2015 Jan;23(1):29-35. doi: 10.1007/s00520-014-2315-z. Epub 2014 Jun 19.
Oral mucositis induced by radiation or chemoradiation can cause devastating quality of life issues for patients undergoing treatment for head and neck cancer. In this study, we investigated the efficacy of a traditional Japanese medicine-Hangeshashinto (TJ-14)-for (chemo)radiation-induced oral mucositis.
Eighty patients who underwent whole neck radiation of >60 Gy with or without chemotherapy (high-dose cisplatin or low-dose docetaxel) were enrolled in this retrospective study; 40 had received TJ-14 during treatment, and 40 had not (controls). Factors related to alleviation of oral mucositis were identified by multivariate logistic regression analysis. Rates of completion of (chemo)radiation treatments were compared between the patients who received TJ-14 and the control group according to the treatment regimen. The comparison of the nutrition status between groups was also performed.
Multivariate analysis indicated that the use of TJ-14 (p = 0.019), gender (p = 0.024), and primary tumor location (p = 0.028) were significant factors associated with the severity of oral mucositis. TJ-14 was associated with a significantly improved rate of completion of chemoradiation with cisplatin (p = 0.002). In the investigation of nutritional status, only serum albumin was significantly maintained better in the TJ-14 group than the control group in terms of mean change before and after (chemo)radiation (p = 0.024).
The present study indicates that TJ-14 is effective for ameliorating oral mucositis induced by (chemo)radiation in patients with head and neck cancers. TJ-14 was associated with improved completion rates of chemoradiation treatments with cisplatin. A randomized controlled trial is necessary to confirm the efficacy of TJ-14 for chemoradiation-induced mucositis in head and neck cancer patients.
放疗或放化疗引起的口腔黏膜炎会给头颈癌患者的治疗带来严重的生活质量问题。在本研究中，我们调查了一种传统日本药物——半夏泻心汤（TJ - 14）对（放）化疗引起的口腔黏膜炎的疗效。
本回顾性研究纳入了80例接受大于60 Gy全颈放疗且接受或未接受化疗（高剂量顺铂或低剂量多西他赛）的患者；40例在治疗期间接受了TJ - 14，40例未接受（对照组）。通过多因素逻辑回归分析确定与口腔黏膜炎缓解相关的因素。根据治疗方案，比较接受TJ - 14的患者和对照组之间（放）化疗治疗的完成率。还对两组之间的营养状况进行了比较。
多因素分析表明，使用TJ - 14（p = 0.019）、性别（p = 0.024）和原发肿瘤部位（p = 0.028）是与口腔黏膜炎严重程度相关的显著因素。TJ - 14与顺铂同步放化疗的完成率显著提高相关（p = 0.002）。在营养状况调查中，就（放）化疗前后的平均变化而言，TJ - 14组仅血清白蛋白显著优于对照组（p = 0.024）。
本研究表明，TJ - 14对改善头颈癌患者（放）化疗引起的口腔黏膜炎有效。TJ - 14与顺铂同步放化疗的完成率提高相关。有必要进行一项随机对照试验来证实TJ - 14对头颈癌患者放化疗引起的黏膜炎的疗效。
