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用芦荟预防急性放射性直肠炎:盆腔癌患者的前瞻性随机、双盲、安慰剂对照临床试验。

Prevention of acute radiation-induced Proctitis by Aloe vera: a prospective randomized, double-blind, placebo controlled clinical trial in Pelvic Cancer patients.

机构信息

Clinical Research Center, Department of Internal Medicine, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran.

Emam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.

出版信息

BMC Complement Med Ther. 2020 May 13;20(1):146. doi: 10.1186/s12906-020-02935-2.

Abstract

BACKGROUND

Acute radiation-induced proctitis (ARP) is the most common side effect following radiotherapy for malignant pelvic disease. This study evaluated the efficacy of Aloe vera ointment in prevention of ARP.

METHODS

Forty-two patients receiving external-beam radiotherapy (RT) for pelvic malignancies were randomized to receive either Aloe vera 3% or placebo topical ointment during radiotherapy for 6 weeks. These patients were evaluated based on the severity (grade 0-4) of the following symptoms weekly: rectal bleeding, abdominal/rectal pain, diarrhea, or fecal urgency. RTOG acute toxicity criteria and psychosocial status of the patients were also recorded weekly. Lifestyle impact of the symptoms, and quantitative measurement of C-reactive protein (CRP), an indicator of systemic inflammation, were also measured.

RESULTS

The results of present study demonstrated a significant preventive effect for Aloe vera in occurrence of symptom index for diarrhea (p < 0.001), rectal bleeding (p < 0.001), and fecal urgency (p = 0.001). The median lifestyle score improved significantly with Aloe vera during RT (p < 0.001). Intervention patients had a significant lower burden of systemic inflammation as the values for quantitative CRP decreased significantly over 6 weeks of follow-up (p = 0.009).

CONCLUSION

This study showed that Aloe vera topical ointment was effective in prevention of symptoms of ARP in patients undergoing RT for pelvic cancers.

TRIAL REGISTRATION

IRCT201606042027N6. Registration date: 2016-09-04.

摘要

背景

急性放射性直肠炎(ARP)是盆腔恶性肿瘤放疗后最常见的副作用。本研究评估了芦荟软膏预防 ARP 的疗效。

方法

42 例接受盆腔恶性肿瘤外照射放疗(RT)的患者随机分为接受芦荟 3%软膏或安慰剂局部软膏治疗 6 周。这些患者每周根据以下症状的严重程度(0-4 级)进行评估:直肠出血、腹痛/直肠痛、腹泻或排便急迫。还记录了 RTOG 急性毒性标准和患者的心理社会状况。每周还测量症状的生活质量影响以及 C 反应蛋白(CRP)的定量测量,CRP 是全身炎症的指标。

结果

本研究结果表明,芦荟对腹泻(p<0.001)、直肠出血(p<0.001)和排便急迫(p=0.001)的症状指数有显著的预防作用。在 RT 期间,芦荟组的中位生活质量评分显著改善(p<0.001)。干预组的全身炎症负担显著降低,因为 CRP 的值在 6 周的随访中显著下降(p=0.009)。

结论

本研究表明,芦荟软膏局部应用可有效预防盆腔恶性肿瘤放疗患者的 ARP 症状。

临床试验注册

IRCT201606042027N6。注册日期:2016 年 9 月 4 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a983/7222341/b933fb3e7e7d/12906_2020_2935_Fig1_HTML.jpg

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