Aim: To evaluate the effectiveness of thymus honey on radiation induced-oral mucositis and xerostomia. Background: Oral mucositis and xerostomia are two of the most severe side effects that head and neck cancer patients confront during and after the completion of radiotherapy. Although several medications are used for their treatment, these fail to provide a fully effective and comprehensive management. Honey and thyme have been studied for the management of various treatment-related side effects. Design: Α double blinded randomised controlled trial will be used for this study. Methods: 200 head and neck cancer patients who receive radiotherapy will be included in this study. Patients will be randomised and divided into two equal groups of 100 participants; the intervention group (oral spray with thyme and honey + standard care) and the control group ( placebo spray + standard care). Assessments with xerostomia and oral mucositis scales additionally to 4 self-administered questionnaires will occur in both groups at baseline and then weekly and 6 months following completion of treatment. The duration of the study will be 3 years from the day of approval of this research protocol.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
QUADRUPLE
Enrollment
200
4 X Sprays in the oral cavity before, immediately after and 6 hours following the radiotherapy session
4 X Sprays in the oral cavity before, immediately after and 6 hours following the radiotherapy session
German Oncology Center
Limassol, Cyprus
RECRUITINGBank of Cyprus Oncology Center
Nicosia, Cyprus
NOT_YET_RECRUITINGChange from baseline in Mucositis Grade (RTOG) at weekly assessments
The scale includes 5 grades (from 0 to IV). Higher grade denotes more severe mucositis
Time frame: Baseline (week 4), week 5, week 6, week 7, week 8 and week 24
Change from baseline in Xerostomia Grade (CTCAE) at weekly assessments
he scale includes 5 grades (from 0 to IV). Higher grade denotes more severe xerostomia
Time frame: Baseline (week 4), week 5, week 6, week 7, week 8 and week 24
Change from baseline in Xerostomia Questionnaire (Dirix et al)
consists of three parts. In the first part, patients rate on a 4-likert scale (0, 1, 2, 3) the intensity of xerostomia, oral pain, taste, and dysphagia they experience and whether they suffered from more intense tooth decay or other related problems. Secondly, patients evaluate the impact of xerostomia on their Quality of Life. The Quality of Life (QoL) scales contains 15 items (ranging from 1 to 5) with a higher score indicating a worst QoL level (minimum score is 15 and the maximum is 75). Finally, patients rate the degree to which they suffered from xerostomia on a 100-mm Visual Analogue Scale (VAS).
Time frame: Baseline, on completion of radiotherapy, 4 weeks and 24 weeks after radiotherapy
Change from baseline in Oral Mucositis Questionnaire (OMWQ)
The 12-item questionnaire is designed to evaluate the overall wellbeing of the patient relating to OM during the last week. Possible answers are scored on Likert scales containing 5, 7 and 11 points. The first 2 questions assess global health and quality of life (QOL). The questions are rated on a 7-point scale, with 1 indicating very poor and 7 indicating excellent. The fourth question, which is made up of 6 items, addresses the impact of MTS on patient function and includes a 5-point scale, with 0 indicating not limited and 4 indicating unable to do. The remaining 3 questions assess the degree of mouth and throat pain and soreness using an 11-point scale, with 0 indicating no pain or soreness and 10 indicating the worst pain or soreness imaginable or possible.
Time frame: Baseline, on completion of radiotherapy, 4 weeks and 24 weeks after radiotherapy
Change from baseline in health-related QoL (EORTC QLQ-C30) questionnaire
The EORTC QLQ-C30 is a cancer-specific self-report questionnaire and comprises a global QOL scale (two items), five functional scales, three symptom scales and six single items. Scores QLQ-C30 are linearly transformed to a scale of 0-100, with a higher score indicating a better level of functioning or global QOL, or a worse level of symptoms or problems
Time frame: Baseline, on completion of radiotherapy, 4 weeks and 24 weeks after radiotherapy
Change from baseline in health-related QoL (EORTC QLQ-H&N43) questionnaire
The EORTC QLQ-H\&N35 module covers specific head and neck issues, comprises ten single items and seven subscales: swallowing, senses, speech, social eating, social contact and sexuality. QLQ-H\&N35 are linearly transformed to a scale of 0-100, with a higher score indicating a better level of functioning or global QOL, or a worse level of symptoms or problem.
Time frame: Baseline, on completion of radiotherapy, 4 weeks and 24 weeks after radiotherapy
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